Nonsurgical management of the boutonniere deformity

Abstract

The present study examined the effectiveness of a 6‐week experimental program of splinting and joint protection education in reducing the progression of the early boutonniere deformity. Nine patients with mild or moderately reducible boutonniere deformities were randomized into experimental and control groups and followed for 1 year. Improvements in active extension of the proximal interphalangial joint for patients in the experimental program suggest that early initiation of a nonsurgical intervention can reduce or reverse progression of the boutonniere deformity in some patients with rheumatoid arthritis. Although the number of patients was small, we conclude that early splinting and joint protection education may limit the anatomical and functional derangements of boutonniere deformity in the rheumatoid hand.

Occupational therapy for rheumatoid arthritis: A systematic review

“…The 2 high quality RCTs (43,44) found no significant differences between groups. Four studies (43,44,65,67) measured range of motion, and in the 2 high quality RCTs (43,44), no significant differences between groups was reported. One low quality RCT (65) demonstrated significant improvement after patients wore an anti-boutonniere splint for 6 weeks.…”

“…Sixteen studies (Table 3) focused on the intervention "provision of splints." Seven of these studies were RCTs/CCTs (21,43,44,(62)(63)(64)(65), and 9 were ODs (49,50,52, 53,66 -70). Within these 16 studies, six different types of splints were evaluated (working splint, resting splint, three types of antideformity splints, air-pressure splint).…”