Souter et al classified fingers showing the Boutonniere ("buttonhole") deformity. This was used for treatment planning and predicting outcome. The authors are from Derbyshire Royal Infirmary.
The Boutonniere deformity is a flexion deformity at the proximal interphalangeal joint with hyperextension of the metacarpo-phalangeal and terminal interphalangeal joints. It is associated with rupture or division of the central slip of the extensor expansion in a finger.
Findings
Group
uncomplicated rupture of the central slip
I
rupture complicated by tissue loss over the PIP joint
II
rupture complicated by fracture of the proximal phalanx
III
rupture complicated by intra-articular fracture of PIP joint
IVa
rupture complicated by gross disruption of the PIP joint
IVb
rupture complicated by multiple severe injuries to the hand
V
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