Swan neck deformity
QT Pathologies (EN)
Swan neck deformity is a finger deformity in which the distal interphalangeal joint (DIP joint) is hyperflexed, and the proximal interphalangeal joint (PIP joint) is hyperextended.
As a result, the finger resemble a swan's neck.
- Swan neck deformities in a rheumatoid arthritis context
- Swan neck deformities in a hyperlax patient
The most common cause of swan neck deformities is Rheumatoid arthritis (see Rheumatoid arthritis section).
In this condition, the volar plate (palmar ligament of the PIP joint) is loosened. This create an imbalance in between extensor and flexor tendons, resulting in a PIP joint hyperextension leading to a DIP joint hyperflexion.
Swan neck deformity may also appear as a result of a mallet finger evolution (See Mallet finger section).
The deformity induce a progressive inability to make a fist. Fingers can't close into the palm.
Pain, swelling and stiffness of joints are common experienced symptoms.
- Impossible coiling of the 4th and 5th fingers and fixed stiffness of the PIP joints (middle joint of the fingers)
Diagnosis is based on clinical examination and the obvious deformation.
X-rays and MRI are needed to explore bones, exclude any fractures and to evaluate ligaments and joints.
Physical therapy and splinting may be used to restore the imbalance, hold the PIP joint in the right position and allow the volar plate healing.
Several surgical options are available to correct a swan neck deformity : repair of the soft tissues, total PIP joint replacement implant, joint fusion (see Osteoarthritis of the fingers section).
During your consultation, Dr. D'Agostino will discuss the current treatment options and can help you choose the best treatment based on your particular case.
- Clinical result of soft tissue repair. Recovery of the winding and extension function of the fourth and fifth fingers.