Swan Neck Deformity

Normal fingers motions occur when there is a balance between the their muscles and ligaments. Disease or injury can disturb the balance in these structures, altering normal finger alignment and function. The result may be a crooked finger, such as a swan neck deformity of the fingers.

Mechanism:

Conditions that loosen the proximal interphalangeal joints (PIP) joint and lead it to hyper-extend, produces a swan neck deformity of the finger. Diseases such as Rheumatoid arthritis (RA) is the most common reason of this deformity. Another cause of Swan neck deformity is Chronic inflammation of the PIP joint which puts stretch on the supportive ligament in front of the PIP joint that would normally stop the deformity. As this ligament becomes weakened and stretched, the PIP joint becomes loose and begins to easily bend back into hyperextension. As the tendon that lifts the finger back becomes out of balance, it allows the distal interphaangeal joint (DIP- shown above) to be pulled downward into a forward bend postiton. As the DIP joint flexes and the PIP joint hyperextends, the swan neck deformity occurs.

Causes:

  • Rheumatoid Arthritis

  • Inflammation of the finger’s joints

  • Hand Trauma

  • Some nerve disorders such as cerebral pulsy, Parkinson or Stroke

Diagnosis:

Usually the diagnosis is evident just from the physical examination by a physiotherapist or doctor. Sometimes a doctor may order X-Ray to see the condition of the joints.

Treatment:

Treatment of Swan neck deformity can be non-surgical or Surgical. Non-surgical treatment is Physiotherapy.

Physio Savvy provides this non-surgical treatment- aiming to restore balance in the structures of the hand and fingers.

We have a stretching and strengthening program as below:

  1. Special forms of stretching to reduce tightness in the finer muscles of the hand and fingers

  2. Strengthening exercises to help with alignment and function of the hand and fingers.

Joint mobilization, stretching,  and muscle release are also used to restore finger alignment and function. In some cases we ask the patient to apply a splint to keep the joints lined up, and protect the joints from over extending.

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Parisa Tanoori

Parisa Tanoori

Physiotherapist at Physio Savvy
Parisa is certified with a Bachelor of Science in Physiotherapy from Shiraz University of Medical Science, Iran. She is currently completing her PhD in Sports Medicine with the special interest of Kinesiology taping in Universiti Malaya.
Parisa Tanoori

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Posted in Musculoskeletal Disorders.