Lesser-toe deformity.

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Abstract

[Indexed for MEDLINE] 2. Clin Plast Surg. 2019 Jul;46(3):329-337. doi: 10.1016/j.cps.2019.02.006. Epub 2019 Apr 16. Managing Swan Neck and Boutonniere Deformities. Elzinga K(1), Chung KC(2). Author information: (1)Section of Plastic Surgery, University of Calgary, Foothills Medical Centre, Room 382, 1403 - 29 Street Northwest, Calgary, Alberta T2N 2T9, Canada. Electronic address: kate.elzinga@ahs.ca. (2)Section of Plastic Surgery, The University of Michigan Medical School, The University of Michigan Health System, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-0340, USA. Acute and chronic injuries to the finger extensor mechanism can result in swan neck and boutonniere deformities. Loss of coordination between the multiple, specialized components of the extensor mechanism results in tendon imbalances leading to altered interphalangeal joint flexion and extension forces. Treatments include corrective splinting and operative interventions. Swan neck deformities are functionally limiting. Surgical correction generally results in functional benefit. Boutonniere deformities are functional but aesthetically displeasing; proximal interphalangeal (PIP) joint flexion and the ability to make a fist are maintained. Surgical improvement can be attempted with caution. Attempts to improve PIP extension can impede flexion, resulting in a poor functional outcome. Copyright © 2019 Elsevier Inc. All rights reserved. DOI: 10.1016/j.cps.2019.02.006