Hand Conditions

Boutonniere Deformity


Disruption of the central slip/band that creates a flexion posture of the proximal interphalangeal joint (middle joint) with concurrent hyperextension posture of the distal interphalangeal joint (furthest joint) due to pathology at the central slip and triangular ligaments.


  • Pain and deformity of the finger
  • Inability to flex the DIP (tip) of finger and extend (straighten) the PIP (middle joint).


  • Disruption of the central slip and triangular ligaments.
  • Traumatic (laceration/cut, direct blow to tip of finger).
  • Degenerative (chronic inflammation, Rheumatoid arthritis)
  • Unopposed lumbricals and collateral bands pull the middle joint (PIP) into flexion and the last joint (DIP) into extension.
  • Pathology creates deformity of the finger and lack of or inability to extend middle joint



  • Early management with strict splinting of the PIP (middle) joint for 3-6 weeks.
  • Occupation Therapy


  • Indicated when non-operative treatment fails.
  • Open tendon injuries and/or PIP (middle) joint injuries that result in an extension deficit of 30 degrees or greater.