Orthopaedics

What Can Be Done For A Swan Neck Deformity Of The Finger ?

The deformed position of the finger where the joint that is most close to the tip of the finger is permanently bent towards the palm. But the joint nearest to the palm is bent away from the palm.

This is called the Swan Neck Deformity.

Mostly injury or inflammations cause this deformity.

Pathophysiology:

The causes of Swan neck deformity generally arises from the

DIP joint, PIP joint or the MCP joint

. All the three cause stretching of the volar plate which make hyperextension of the joint and damaging the

extensor tendon

. Thumb cannot have true Swan neck deformity as it contains lesser joints. A similar condition as in with Swan neck deformity, also is seen in

thumb

known as the Duck bill deformity.

Non-surgical Treatment Methods:

The treatment methods can be nonsurgical or surgical. The flexibility and stiffness decides over the use of the treatment mode.

  • The goal of the nonsurgical treatments is to restore the normal balance in the finger and hand structures. The PIP joint must not be stiff. To restore the the DIP extension it is important to

    align the PIP joint

    and prevent hyperextension. If this does not work, surgery may be required.

  • The imbalances may also require professional rehabilitation methods like physical therapy or occupational therapy.

    Stretching, massaging and mobilization

    of the joint are used by the occupational and the physical therapist to restore the alignment and function of the finger.

  • A

    special splint

    may be used which would protect the PIP joint from hyperextending and keeping it lined up, but also allowing easy and proper bending of the joint. In cases where the PIP joints are not stiff, specially shaped splints may be used resembling jewelry rings. They may be made up of gold, sterling silver or stainless steel.

  • Before performing surgery, the physician observes the improvement of joint mobility for about 6 weeks with

    splints and exercises

    . In most cases, splinting and therapy program are not very successful. Alteration of imbalances causing deformity is not an easy task.

Non-surgical Rehabilitation:

  • The prime goal of all non-surgical treatments is to maintain the joints, muscles and tendons of the finger in balance.
  • The improvement will be felt in about 8-12 weeks.
  • The mutual cooperation between the patient, doctor and the physical or occupational therapist is the deciding factor for its success during this time.
  • Finger splint may be used during this therapy.
  • Special stretching methods are used to reduce the tightness in the intrinsic muscles.
  • Few other strengthening exercises may also help in aligning and maintaining the functioning of the hand and fingers.

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