In BD, the tendon on the top of the finger (called central slip) is torn or cut from the other tendons. This creates a tear that resembles a buttonhole (or
in French). The middle joint is forced down, and the fingertip bends back. The tendons on this part of the finger are flat and thin. They are prone to injury. If you have BD in the thumb, it affects a joint called the metacarpophalangeal (MCP).
BD can be caused by:
Powerful blow to the bent finger
Cut to the finger’s central slip
Injury to the middle finger joint (called the proximal interphalangeal [PIP] joint)
Severe burn on the hand
These factors increase your chance of developing BD:
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Your doctor may recommend the following medications:
Corticosteroids—to reduce inflammation
Nonsteroidal anti-inflammatory drugs (NSAIDS)—to reduce pain and inflammation
For milder cases, the treatment is nonsurgical and may involve:
Applied to the middle joint to fully extend it
Used for 3-6 weeks
Stretching and strengthening exercises
, ultrasound therapy, electrical stimulation
If your finger does not improve, you may need surgery.
Surgery is needed in severe cases. This may include when the tendon is cut or when the deformity has lasted a long time. Surgery generally does not return your finger to the way it was working before the injury. But, you may have some improvement. After surgery, you will have to do exercises to strengthen the finger.
To help reduce your chance of getting BD, take the following steps:
Wear the proper equipment when playing sports.
If you have rheumatoid arthritis, ask you doctor about ways to protect your joints.
Functional thumb orthosis for type I and II boutonniere deformity on the dominant hand in patients with rheumatoid arthritis: a randomized controlled study. EBSCO Publishing Consumer Health Complete website. Available at:
. Updated August 2008. November 10, 2008.
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a