Swan neck deformity

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Swan neck deformity
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Hyperextension of the proximal interphalangeal joint and flexion of the distal interphalangeal joint
Complications	Functional impairment, pain
Onset	Gradual
Duration	Chronic
Types	N/A
Causes	Rheumatoid arthritis, trauma, Ehlers-Danlos syndrome, cerebral palsy
Risks	Joint laxity, inflammatory arthritis
Diagnosis	Physical examination, X-ray
Differential diagnosis	Boutonniere deformity, mallet finger
Prevention	N/A
Treatment	Splinting, physical therapy, surgery
Medication	N/A
Prognosis	Variable, depending on underlying cause and treatment
Frequency	Common in rheumatoid arthritis patients
Deaths	N/A

Swan Neck Deformity is a condition characterized by the flexion of the distal interphalangeal joint (DIP) and hyperextension of the proximal interphalangeal joint (PIP) of the fingers, giving the finger a shape reminiscent of a swan's neck. This condition can significantly affect hand function and aesthetics.

Introduction

Swan Neck Deformity is often associated with rheumatic diseases, such as Rheumatoid Arthritis, but can also result from trauma, ligament laxity, or congenital conditions. The deformity arises from an imbalance in the tendons and ligaments that control finger movements, leading to the characteristic finger posture.

An example of Swan Neck Deformity. (Placeholder image)

Causes

The primary causes of Swan Neck Deformity include:

• Rheumatoid arthritis which causes inflammation and changes in the joints and ligaments.
• Traumatic injuries to the fingers that affect the ligaments.
• Congenital conditions present at birth.
• Neuromuscular diseases that affect the balance of muscle forces around the joints.

Symptoms

Symptoms of Swan Neck Deformity may include:

• Difficulty in bending the finger at the affected joint.
• Pain and discomfort in the finger, especially when trying to flex.
• Cosmetic concerns due to the appearance of the finger.

Diagnosis

Diagnosis of Swan Neck Deformity involves a physical examination by a healthcare provider, who may also request imaging tests, such as X-rays, to assess the extent of the deformity and rule out other conditions.

Treatment

Treatment options vary based on the severity of the deformity and the underlying cause, including:

• Non-surgical treatments such as splinting, to help realign the finger joints and reduce the deformity.
• Occupational or physical therapy to strengthen the muscles and improve joint function.
• Surgical intervention in severe cases to correct the deformity, which may involve tendon transfers, joint fusion, or other procedures.

Prevention and Management

While it may not always be possible to prevent Swan Neck Deformity, especially in cases related to genetic conditions, managing underlying diseases like rheumatoid arthritis can minimize the risk of developing the deformity. Regular follow-up with healthcare providers and adherence to treatment plans are crucial.

External Links

• Arthritis Foundation
• American Academy of Orthopaedic Surgeons (AAOS): Hand & Wrist

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