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Swan neck deformity has many of possible causes arising from the DIP, PIP, or even the MCP joints. In all cases, there is a stretching of the volar plate at the PIP joint to allow hyperextension, plus some damage to the attachment of the extensor tendon to the base of the distal phalanx that produces a hyperflexed mallet finger.
Boutonniere deformity is a deformed position of the fingers or toes, in which the joint nearest the knuckle (the proximal interphalangeal joint, or PIP) is permanently bent toward the palm while the farthest joint (the distal interphalangeal joint, or DIP) is bent back away (PIP flexion with DIP hyperextension).
Dislocations can occur in any major joint (shoulder, knees, hips) or minor joint (toes, fingers). The most common joint dislocation is a shoulder dislocation. [1] The treatment for joint dislocation is usually by closed reduction, that is, skilled manipulation to return the bones to their normal position. Only trained medical professionals ...
Severing of the central slip by lacerations or a dislocation of the middle phalanx towards the bottom of the finger causes the tendon to tear off the bone [1] A secondary cause of boutonnière deformity is rheumatoid arthritis causing chronic inflammation that eventually results in tendon damage.
Dislocations can be categorized based on the direction that the fingertip moves in relation to the knuckle. [6] If in the direction of the palm, it is a volar dislocation. If in the direction of the back of the hand, it is a dorsal dislocation. [6] If in the direction to either side, it is a lateral dislocation. [2]
If patients do have median nerve palsy, occupational therapy or wearing a splint can help reduce the pain and further damage. Wearing a dynamic splint, which pulls the thumb into opposition, will help prevent an excess in deformity. This splint can also assist in function and help the fingers flex towards the thumb.
There is limited and limited quality evidence regarding splints, corticosteroid injections, manual therapy and other palliative measures. Studies with adequate randomization, blinding, and independent assessment are lacking. Arthrodesis fuses the TMC joint. It is uncommonly used. [26]
Buddy wrapping, also called neighbour strapping [1] or buddy taping, is the act of bandaging a damaged or particularly a fractured finger or toe together with a healthy, uninjured one. The bandage or medical tape is usually stiff, not allowing the digits to move; the healthy digit acts as a splint , keeping the damaged one in a natural position ...
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