Finger Deformity
One Orthopaedics - Hand Surgeons in Guildford, Surrey
Table of Contents
What is a Finger Deformity?
Finger deformities can be congenital (present at birth), caused by injury, or secondary to a condition such as arthritis.
Typically, doctors base the diagnosis of hand and finger deformities on an examination. If the appearance of the deformity suggests a condition has caused it, they may also consider further tests.
In this article, we’ll talk you through:
- The symptoms and causes of finger deformity
- The types of deformed fingers
- How we treat finger deformities
What Causes Finger Deformity?
Finger deformities can be the result of an imbalance of different muscle groups caused by nerve dysfunction, or due to congenital defects. They can also occur from overuse or repetitive motions of the hand.
Fractures that are not well treated, and the destruction of joint cartilage or ligaments, can also lead to deformity.
Finger Deformity Symptoms
Depending on the cause, there are a number of symptoms that occur alongside the changed appearance.
These include:
- Pain in the joint, including on movement
- Stiffness and difficulty moving joints
- Fingers getting stuck in position
- Grinding of the joint
How is Finger Deformity Diagnosed?
An examination of your hand and fingers will allow your consultant to determine whether or not you have a finger deformity and if so which type it is.
They may ask you to perform certain movements to confirm a diagnosis, and may consider tests such as:
- X-rays
- Blood tests
- Specialist referral
Finger Deformity Types
There are a range of finger deformity types. Finger deformities may be caused by an injury or can arise from another disorder, for example rheumatoid arthritis.
Finger deformities can be diagnosed by a doctor on an examination. In order to receive the correct treatment, it is important to distinguish the type of deformity. The different types include:
The different types include:
- Trigger Finger
- Swan Neck Finger Deformity
- Boutonniere Deformity
- Mallet Finger Deformity
- Drop Finger Deformity
- Dupuytren’s Contracture
- Finger Deformity after Injury
Trigger Finger
Trigger finger deformity occurs when the tendon in your finger or thumb becomes irritated. This makes it difficult for your finger to straighten. It can feel like your finger gets stuck in a bent position and then suddenly pops straight. It may feel like locking or catching when you bend and straighten your digits.
The ring finger and thumb are most commonly affected digits. However, the condition can affect any of the digits. Common causes include repetitive hand movements or conditions like arthritis. Treatment options include:
- Rest
- Splinting
- Medication
- Surgery if needed.
Swan Neck Finger Deformity
This condition affects the middle joint of the finger. The middle joint of the finger bends back while the tip of your finger bends inwards. This looks like the curve of a swan’s neck.
Symptoms can include pain and difficulty straightening the finger. Rheumatoid arthritis is the most common cause.
Treatment Options:
- Ring splint: to keep the finger in the right position.
- Extension block splint: prevents excessive movement of the middle joint in the finger
Boutonniere Deformity vs Swan Neck
Boutonniere deformity and Swan neck deformity are two types of finger deformities that affect how your fingers bend and straighten, but they happen in different ways.
Both deformities can cause pain, stiffness, and difficulty moving the fingers.
Treatment may involve:
- Splinting
- Exercises
- Surgery: Depending on the severity and underlying cause.
Consultation with a hand doctor is crucial for proper diagnosis and tailored management.
| Boutonniere Deformity | Swan Neck Deformity | |
|---|---|---|
| Description | Middle joint bends inward while end joint stays straight, resembling a buttonhole | End joint bends backward like a swan’s neck, middle joint may bend inward abnormally |
| Signs and Symptoms | Difficulty straightening the finger, pain, stiffness | Difficulty with gripping, pain, stiffness, finger bending abnormally |
| Diagnosis | Physical examination, X-rays | Physical examination, X-rays |
| Treatment | Splinting, exercises, surgery | Splinting, exercises, surgery |
| Common Causes | Injuries, Arthritis | Rheumatoid Arthritis, Injuries |
Boutonniere Deformity
A boutonniere deformity is a condition affecting the middle joint of your finger. The middle joint bends inward while the joint at the end sticks out straight or bends upwards. It is the opposite of the Swan Neck Deformity.
It is usually caused by a forceful blow or injury damaging the tendon on the top of the finger. Symptoms include difficulty straightening the middle joint and pain.
A splint can be used to keep the middle joint straight. Exercises to strengthen the joints are also important. Strengthening the joint at the top of the affected finger is particularly important.
Mallet Finger Deformity
Mallet finger deformity occurs when the tendon of your finger gets injured. It is often caused by a sudden force to the finger. This tendon is what lets you straighten the end joint of your finger.
The injury causes the top of your finger to droop and prevents you from straightening it. Symptoms include pain and inability to fully extend and straighten the finger.
Treatment involves wearing a splint to keep the finger straight so the tendon can heal.
What’s a Drop Finger Deformity?
A drop finger deformity is just another name for Mallet Finger. It’s also known as baseball finger.
There isn’t really a difference between the three terms – they are just known more commonly as different things depending on your location!
Dupuytren’s Contracture
Dupuytren’s contracture is a condition where the tissue under the skin of your palm gets thicker. This makes the palm tighter. This then causes one or more fingers to curl inward. The ring and little fingers are usually most affected.
The condition can begin as small hard nodules that form under the skin of the palm. These worsen over time until you can no longer straighten the fingers. Luckily, there is treatment available for this condition.
The exact cause is unknown, it often runs in families and can be linked to factors like age and smoking.
Finger Deformity After Injury
Injuries like fractures and dislocations can result in finger deformities. This is because of the trauma’s impact on bones, ligaments, and tendons. Both mallet finger and swan neck deformities are common deformities that result from injury.
Common types of injuries that can lead to deformities include:
- Phalanx Fractures: These fractures can occur at different locations along the finger bones, such as the distal phalanx (tip), middle phalanx, or proximal phalanx (closer to hand). They can result from direct trauma or crushing injuries.
- Metacarpal Fractures: Fractures of the metacarpal bones typically result from a direct blow to the hand or a fall onto an outstretched hand. These fractures can affect the alignment and function of the fingers.
- Dislocations: Finger dislocations involve the displacement of bones at the joints, commonly occurring at the proximal interphalangeal (PIP) joint or the distal interphalangeal (DIP) joint. Dislocations often accompany fractures or severe ligament injuries.
These conditions often result in pain, stiffness, and damaged finger function. It is important for your doctor to check the injury. They will be able to check how severe the injury is and start treatment.
Avoiding Deformed Fingers After Injury
Non-surgical treatment may involve:
Sometimes, surgery is required to realign the affected structures. Examples of this include trigger release, fracture surgery, and tendon transfer.
Early intervention enhances recovery and reduces the risk of long-term deformities. Regular follow-up appointments with your consultant are important. Your consultant can track your healing progress and make any changes if necessary.
Finger Deformity from Arthritis
Arthritis can lead to different finger deformities. These can affect the structure of the joint and its function.
Common types of Arthritis:
These can cause joint inflammation, erosion, and deformity.
These conditions may result in symptoms like pain, swelling, and restricted movement. They can lead to deformities like Swan neck or Boutonniere deformity. Early detection by the doctor is vital for improving finger function and quality of life.
Types of Deformities Caused by Osteoarthritis
Osteoarthritis is the most common type of arthritis. It can lead to several types of finger deformities. This is because of damage to the joint and loss of cartilage.
One common deformity is Heberden’s nodes. This causes large amounts of bone to grow at the end joints of the fingers.
These nodes can cause:
- Pain
- Stiffness
- Limited mobility
Another deformity is Bouchard’s nodes. These are similar bony growths but occur at the middle joints of the fingers. Both Heberden’s and Bouchard’s nodes are linked with osteoarthritis.
Osteoarthritis may also lead to joint contractures. This is when the joints become permanently bent. This is because of loss of cartilage and thickening of nearby tissues. These deformities can impact hand function and quality of life.
Early diagnosis by a doctor and treatment is important. This can help reduce your symptoms and prevent it from getting any worse. Your doctor may recommend making changes to your lifestyle or offer treatment.
Deformities Caused by Rheumatoid Arthritis
Rheumatoid arthritis (RA) can cause changes in your fingers and hands. This can affect how they look and their function.
One common change is when the joints in your fingers become swollen and bent. Leading to what’s called a ‘Swan neck’ deformity. This is where your finger bends backward at the end and may bend inward in the middle.
Another change is ‘Boutonniere’ deformity. This is where the middle joint bends inward while the end joint stays straight.
RA can also make your fingers drift sideways. This causes the joints to breakdown, making them unstable. These changes can make it harder to do everyday tasks and may cause pain and stiffness.
Treatment can include:
- Medications
- Physical therapy
- Surgery
These can help manage symptoms and prevent these finger changes from getting worse.
Regular check-ups with your consultant are important to watch your condition. They can adjust your treatment if needed to keep your hands functioning as well as possible.
Treatment
The treatment for deformed fingers will depend on the cause and location of the deformity, as well as the severity.
When you see a hand specialist at One Orthopaedics in Guildford, we will explain the benefits of the different treatment options and the likely recovery.
Non-Surgical Treatment
For damaged fingers, your consultant may provide splints to wear and exercises to perform at home. Warm baths are sometimes recommended to ease the pain and you may be given suggestions as to how to use your hand differently to ease symptoms.
You may also be offered steroid injections if your consultant believes this is the appropriate treatment for your particular condition.
Anti-inflammatory medications can be helpful in early stages where there is pain and swelling. Steroid injections may also be recommended to reduce swelling. If the injections fail to give a lasting benefit, then surgical options will be considered.
Surgical Treatment
In some cases, when symptoms are severe, or in those for whom more conservative treatments have not worked, surgery may be the best option.
Whether surgery is recommended will depend on how much pain you’re in, whether it’s associated with other medical problems, and how much it’s affecting your life.
Most finger deformity operations can be done under local anaesthetic and are usually day cases.
Treatment options
The One Orthopaedic team specialists
Anthony Hearnden
Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Shoulder, Elbow, Hand and Wrist
