Boutonniere deformity
If the middle joint of your finger stays bent after an injury and you find it difficult to straighten, a damaged tendon may be the cause.
Earlier answers
Getting the right support
Being seen early can help you understand what’s happened and start the right treatment fast.
A clear diagnosis
Understanding your injury
Your specialist will carefully examine your finger and arrange scans for a clearer picture.
Support during recovery
Helping you move comfortably
Specialist hand therapists can help with splinting and guide your rehabilitation.
What is boutonniere deformity?
Boutonniere deformity is a change in your finger’s position due to damage to the tendon on the back of the middle joint. This tendon helps straighten your finger and is part of a group of straightening tendons (extensor tendons). If its middle section is injured, the middle joint can stay bent while the fingertip bends backwards. You may also find it harder to bend the end of your finger normally. The name comes from the French word for ‘buttonhole’, which describes the shape of the tendon injury.
What causes boutonniere deformity?
A common cause is a hard knock to the top of the middle joint while your finger is bent. This might happen if you jam your finger during sport or another everyday activity.
A deep cut across the back of the finger can also damage the tendon. The condition can follow an injury if the middle joint is knocked out of position (dislocated). In some cases, arthritis can weaken the tissues around the joint and lead to the same change in finger position.
What are the symptoms of boutonniere deformity?
Some symptoms can start soon after you hurt your finger, although the change in its position may not become obvious until days or even a few weeks later.
You may notice:
- Pain around the middle joint
- Swelling after the injury
- Difficulty fully straightening the middle joint
- Difficulty bending your fingertip
In the early stages, the injury can look and feel like a simple finger sprain. If your finger remains sore or you still can’t straighten it properly, it’s a good idea to have it assessed.
How is boutonniere deformity diagnosed?
Your specialist will ask what happened and closely examine your finger’s position and range of movement. They may ask you to straighten the middle joint or bend your fingertip to understand how the damaged tendon is working.
Imaging scans may be the next step in your diagnosis journey. An X-ray can show whether there’s also a broken bone and if the joint is still properly lined up. In some cases, an ultrasound scan may provide a closer look at the tendon.
How is boutonniere deformity treated?
Starting treatment early is important because the finger can become harder to correct if it stays in a bent position for too long.
Many recent injuries can be treated without an operation. A splint can often hold the finger in the right position while the damaged tendon heals. If the injury is more severe, orthopaedic surgery (an operation on the bone, joint or soft tissue) may be recommended.
Your specialist will explain your options in everyday language, including what each approach is designed to achieve and what recovery could look like for you.
Treatment routes for boutonniere deformity
For many injuries, treatment starts with a splint. The splint keeps the middle joint straight so the tendon has a chance to repair itself, while usually allowing you to keep moving the fingertip.
You’ll generally need to wear it continuously for several weeks. Splinting typically lasts around four to eight weeks, although your specialist will advise you based on your injury and progress.
A hand therapist can make sure your splint fits comfortably and show you which movements are safe. Following their guidance is important, as bending the middle joint too soon can put extra strain on the healing tendon.
Recovery goals after boutonniere deformity treatment
Phase 1 goals:
Protect your repaired finger in its splint Keep swelling and discomfort manageable Allow the wound to begin healing Follow the safe movements shown by your hand therapist
Phase 2 goals:
Continue protecting the tendon as it heals Gradually introduce controlled finger movement Build confidence in using your hand safely Adjust your splint when your care team advises
Phase 3 goals:
Gradually spend less time in your splint Build more movement into everyday activities Begin improving finger strength when it’s safe Work towards the activities that matter to you
Working with Hand and Wrist professionals and teams
Our hand and wrist specialists support professional athletes, sports teams, active individuals and people whose work places high demands on their hands and wrists. Working closely with radiologists, physiotherapists and the wider multidisciplinary team, they provide coordinated care from diagnosis through to rehabilitation, helping each person return safely to sport, work or everyday activities.
The same specialist expertise and collaborative approach are available to every patient, whatever your activity level or recovery goals.
Our Experts - Leaders in Hand and Wrist treatment
How to pay
We offer flexible options depending on how you choose to access care at Fortius. Whichever option you choose, we’ll help make the process clear and straightforward from the start.
Private medical insurance
If your care is covered by private medical insurance, we’ll usually invoice your insurer directly. Please check your policy in advance and request an authorisation code if your insurer requires one. You’ll be responsible for paying any policy excess or costs that aren’t covered by your insurance.
Paying for yourself
You don’t need private medical insurance to access care at Fortius. If you’re paying for your own treatment, our team will explain the costs clearly and provide a personalised quote before you decide whether to go ahead.
Find a clinic near you
Fortius Clinic City
Our City Clinic is conveniently located between Bank and Monument stations, within the historic and financial heart of London. At our modern, two-floor facility we have nine consulting rooms, spacious waiting areas, well equipped treatment rooms and an imaging centre.
Explore our City Clinic with our virtual tour.
If you are travelling by Tube, our closest underground stations are Bank and Monument, exit 6 for King William Street.
Should you be travelling by car, the closest parking is a three minute drive away at NCP Car Park London Vintry Thames Exchange. If you are attending clinic on a weekday, please be aware that we are based in the congestion charge zone.
- 75 King William StreetEC4N 7BE
- 0203 195 2442
- Monday to Friday from 8.00am to 8.00pm.
- Snow Injuries Clinic
- Tendon
- Sports & Exercise Medicine
- Ultrasound
- X-Ray
- Physician services
- Rheumatology
- MRI Scan
Fortius Clinic Marylebone
Our Marylebone Clinic is conveniently located in the historic area between Baker Street and Marylebone High Street, just off Manchester Square, home to the iconic Wallace Collection. We have seven consulting rooms, private waiting areas on each floor, well equipped treatment rooms and diagnostic imaging.
- 17 Fitzhardinge StreetW1U 2EU
- 020 3195 2442
- MRI Scan
- Ultrasound
- X-Ray
- Physician services
- Rheumatology
Fortius Clinic Marylebone Wing
Our 79,000 sq ft, seven-story, private hospital on Wigmore Street has 39 en-suite inpatient rooms, consultation and treatment rooms, and a physiotherapy suite.
The hospital has a high-spec imaging suite fully equipped with an MRI, CT scanner and X-ray machine. There are three state-of-the-art operating theatres, two anaesthetic rooms and a recovery bay.
Fortius Clinic London has two Mako robots for hip and knee joint replacements.
- 66 Wigmore StreetW1U 2SB
- +442031952442
- Open 24 hours
- Sports & Exercise Medicine
- Snow Injuries Clinic
- Tendon
- Ultrasound
- X-Ray
- Physician services
- Rheumatology
- CT guided injection
- MRI Scan
- CT Scan
Fortius Clinic Wimbledon
Our Wimbledon clinic houses a state-of-the-art imaging centre with a 3T MRI and X-ray scanners, Ultrasound, seven consulting rooms, two spacious waiting areas and well equipped treatment rooms all located on one level, ensuring easy accessibility for all patients.
Our partnership with Spire St Anthony’s Hospital allows us to provide orthopaedic surgery closer to our clinic. We treat a full range of conditions and perform joint replacement surgery using the latest Mako robotic assisted technology.
Take a tour of our clinic virtually through Google 360 views here.
We are open Monday to Friday from 8.00am to 8.00pm, and Saturday mornings from 8.30am to 12.30pm.
If you are travelling by Tube, our closest underground station is Wimbledon (District Line), which also has rail and tramlink services from central London and beyond.
There is no parking available at the clinic, but we have a number of parking facilities all within a 10-12 minute walk of the clinic: Centre Court Car Park, Broadway Car Park, and Hartfield Road Car Park. Please note that all of these facilities are paid car parks.
The building at 22 Worple Road has steps leading up to the front entrance. If you require assistance please inform us before your arrival by calling ahead on 020 3195 2442
- 22 Worple RoadSW19 4DD
- 0203 195 2442
- Snow Injuries Clinic
- Ultrasound
- X-Ray
- MRI Scan
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