Boutonniere Deformity Surgery

A boutonniere (say “boo-tuh-NEER”) deformity is an injury to the tendon that runs over the middle joint of a finger. The injury causes the middle joint to bend down and the end joint to bend up. When you have this injury, you can’t straighten your finger.

“Boutonniere” is French for “buttonhole.” The injury often causes an opening in the tendon that looks like a buttonhole.

It can also be caused by rheumatoid arthritis, which causes pain, stiffness, and swelling in the joints.

Your doctor may try using a splint to see if the injury heals. If a splint doesn’t work or there are other problems, your doctor will talk to you about surgery. Surgery involves making a cut in the skin over the joint and fixing the tendon.

You will probably be able to go home after the surgery. Your doctor may put a splint on your hand or finger after the surgery. If so, wear it exactly as directed. Do not remove it until your doctor says that you can.

Preparing for surgery

How do you prepare for boutonniere deformity surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

The day of surgery

What happens on the day of boutonniere deformity surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
  • The surgery will take about 90 minutes.

After surgery

How can you care for yourself after boutonniere deformity surgery?


  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.

Incision care

  • You may wash your hands and shower after 2 or 3 days, if your doctor okays it. Pat the incision (the cut the doctor made) dry. Do not take a bath, swim, use a hot tub, or soak your hand until your doctor says it is okay.

Ice and elevation

  • Put ice or a cold pack on your hand for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice and your skin.
  • Prop up the sore hand on a pillow when you ice it or anytime you sit or lie down during the next 3 days. Try to keep it above the level of your heart. This will help reduce swelling.

Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.


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