Swan-Neck Deformity

Swan-Neck Deformity

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Recommended Exercise

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Swan-Neck Deformity

Hand

What is Swan-Neck Deformity?

Swan-neck deformity is a condition that causes the fingers to bend inward (flex) at the base and straighten out (extend) at the middle joint. The outermost joint may also flex to some extent.

This can cause pain and swelling in the fingers, as well as difficulty moving them. People with swan-neck deformity may experience difficulty gripping objects or opening jars because of the increased strain on their fingers.

What are the types of Swan-Neck Deformity?

There are three types of Swan-Neck Deformity

Type I

In this type the proximal interphalangeal (PIP) or middle joint is flexible in all positions. The flexor tendon inserts at a site that has poor leverage for bending. The PIP joint can be bent in certain positions while maintaining tightness in other positions of flexion/extension.

Type II

In this type, the middle joint can bend in certain positions but is stiff in others.

Type III

The middle joint cannot be bent in any position of the finger(s). Patients with this type do not experience pain unless something causes their fingers to be straightened beyond their normal range of motion (i.e. when putting on gloves, rings, etc.).

What are the causes of Swan-Neck Deformity?

The main cause of this type of deformity is weakening or tearing of the ligament that runs across the palm side of the middle joint of the finger. The middle joint is also called the proximal interphalangeal joint. This part of the finger bends toward the second knuckle (the one closest to your fingernail).

A swan neck deformity may also be caused by tearing of either one of two tendons that attach to the middle joint:

1) The flexor tendon, which attaches to the middle finger joint and allows it to bend

2) The extensor tendon, which attaches to the back part of that same joint and straightens it.

These two tendons may tear in combination with each other and with the ligament. The result is a sideways bend in your finger. When both tendons are torn and when the ligament is torn, your finger will be bent upwards at its end joint. A person

What are the symptoms of Swan-Neck Deformity?

Symptoms of Swan-Neck Deformity includes:

  • The middle joint of your finger may feel stiff and difficult to move. This can make everyday activities like opening doors or turning doorknobs difficult or painful.
  • If you have this condition, you may hear a snapping sound when you bend your middle joint or straighten it out again after bending it back toward your palm (flexion). You might also feel pain at the base of your middle joint when you open and close your hand completely (extension).
  • This problem often makes it difficult for you to bend your affected finger backward toward your palm (extension).

What are the risk factors for Swan-Neck Deformity?

The risk factors for developing this problem are pretty simple: it can happen to anyone who has had a serious injury to their hand, who has a history of arthritis, or who has other conditions that cause nerve damage.

A ruptured tendon or mallet finger is two of the most common causes of swan-neck deformity. Some people develop it after they’ve had surgery on their hand, and others have no identifiable cause at all.

Recommended Exercise

Hand

What are the exercises for Swan-Neck Deformity?

To treat swan-neck deformity, you can begin with exercises that flex the middle joint and extend the base of your finger. You can also do exercises to flex your finger’s outermost joint.

Flexion

Extend your middle finger and hold it straight. Flex your ring finger at its base until you feel resistance. Hold for 15 seconds and repeat 10 times per day.

Extension

Extend your middle finger and hold it straight. Bend your ring finger until you feel resistance in the joint. Hold for 15 seconds and repeat 10 times per day.

Finger Adduction and Abduction

To do this exercise, sit in a chair or stand with your feet shoulder-width apart. Bend your elbow, and pretend like you are touching the tip of your thumb to your shoulder. Then move your thumb outward as far as possible (away from the shoulder). Do this 10 times each side. This exercise helps strengthen the muscles that flex your fingers and extend them.

Finger Passive Range of Motion

This exercise involves bending and straightening each finger at least 10 times per day for three or four weeks. You should start with just one finger at a time, then work up to all five fingers at once—or even all 10 fingers! This is an important exercise because it will help keep your joints flexible and strong for years to come!

What are the treatments for Swan-Neck Deformity?

There are a variety of treatments for Swan-Neck Deformity, though it is important that you do not self-treat if you suspect you have it! Your doctor will be the best resource for determining if you have this condition, as well as the best course of action to treat it.

Hand therapy

There are many kinds of hand therapy that your physician may suggest that focuses on keeping your fingers and hands moving. The more active your hands, the less likely you are to have stiffness and pain.

The goal of these therapies is to keep your joints moving through their full range of motion so there is no joint contracture and your fingers aren’t shortened or bent uncomfortably. These treatments include tendon gliding, joint mobilizations, and surface electromyography biofeedback.

Extension Block splint

An extension block splint may correct the excessive movement of your middle joint by bringing your DIP joint back into place. It does this by holding the joint in a slightly bent position when you’re not using it. Extension Block splints are rigid splints that completely immobilizes the fingers and thumb in extension, preventing further damage. They do not allow movement in the joints, so they are only useful for short-term treatment. Usually, they are worn at night for about three weeks before you progress to a more flexible splint or another form of therapy.

Progressive Extension Splint

A progressive extension splint, which can only be prescribed by a doctor, is another option for treating swan-neck deformity. This type of splint holds your middle joint in a bent position during use, and then allows it to straighten out as you release your finger from the grip (like how a rubber band works).

Explanation of Recommended Orthotic Device

Hand

What brace is used for Swan-Neck Deformity?

Swan-neck deformity refers to a condition where the fingers are excessively hyper-extended, bent backward at the middle joint of the finger. It is often mistaken for trigger finger, which is a different condition that causes the finger to lock in place, rather than being hyper-extended. An Oval-8 is a type of splint used for this condition.

The splint consists of a continuous metal ring connected with hinges on each side and closing with clasps on either side. The ring is wrapped around the base of the finger and its opening is placed over the middle joint of the finger to secure it against hyperextension. 

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