[richdraws]

Hello you.

Right, I have a very crooked finger me. Spannered it up on a hold that spun at rock antics a way back. The type of injury was described as boutonaire? Basically I have range of motion in the tip of the finger joint and the base of the palm/ finger joint but very very limited movement in the middle joint.

I was initially told by the doctors and finger specialist that, not much could be done to rectify the problem. I think it was gaz parry that said he had heard of someone having his tendon lengthened?

Does anyone have any knowledge of this type of injury or surgery?

I would love a happy ending to this finger nightmare xxx

[GCW]

Sorry, I ain't giving good news.
1.  It's hard to comment as I haven't seen the digital disaster in question.
2.  Sounds like a central slip rupture. 


Bend you wrist and MCP joints (knuckles).  Can you straighten the finger in that position?
3.  Diagnosed at the time of injury (or suspected, but you have to be looking for it) a splint for 6 weeks usually heals it.  Later, once the deformity is there things ain't so rosy.
4.  Can you make the finger look normal by manipulating it with your other hand?  If not, you're stuck with it.
5.  If the deformity corrects, there are a few operations aimed at sorting it out, which generally means none are particularly successful.
6.  Listen to you hand surgeon, but you can always get a second opinion- it is your right.

[GCW]

No other replies?  I am a little surprised.
Let us know what the outcome is of you Quadrospazzing.  All the best

[fatdoc]

got to this thread late... sorry...

the above is sound advice IMO.

At the edge of my knowledge base though... but the ability to straighten is gonna be vital to gain function back i'd have thought.. if it's fixed I dunno what can be done...

as above , there is no harm in asking for a 2nd opinion... if you've been told it's knacked then i'd defo get another opinion... but at the end of the day i really cant give you a long term outcome mate.

good luck.

[GCW]

but the ability to straighten is gonna be vital to gain function back i'd have thought..

Straightening isn't the main concern.  The fact you have lost the central slip (assuming this is the problem) means you will get the lateral bands slipping towards the palm, this slowly worsening the flexion at the PIP joint.  By intrinsics and long extensor imbalance you will get progressive hyperextension at the DIP joints resulting in a Bouttoniere deformity.  Once this has been present a while you get capsule and volar plate contractures in the PIP joint making the deformity permanent and the only surgical option is likely to be fusion.
Get it seen to RichDraws, but let us know how you get on.  Good luck