This article is about the Swan Neck Finger Deformity. It includes the causes, diagnosis and treatment. The information can also be seen in part of the following video.
A swan neck deformity is a fairly common finger deformity where the middle finger (PIP) joint bends backwards the wrong way, a position called hyperextension. And then the end finger (DIP) joint adopts a compensatory flexed position. So the overall finger position resembles the position of a swans neck.
And if you have a swan neck deformity you might struggle with gripping, making a fist and with fine dexterity activities. The PIP joint might also snap or flick suddenly from the hyperextend position to the flexed position when you try and make a fist.
Swan necks can be painful but not usually. It’s more of a finger movement problem than a painful problem in most cases. There can be many causes of a swan neck deformity but the most common ones are as result of Rheumatoid Arthritis, due to an Injury or as a result of having hypermobile joints such in Hypermobility Syndrome or Ehlers-Danlos Syndrome.
And with all these causes, the result is the same. An imbalance in the way the extensor tendon works. Essentially a set of ligaments on the flexor side of the PIP joint, collectively called the volar plate becomes torn or lax which then causes the joint to hyperextend. The volar plate can tear or become overstretched due to a finger injury, where the PIP joint becomes forcible bent backwards but it can also happen due to the erosive effects of chronic inflammation like we see in Rheumatoid Arthritis.
If your swan neck deformity happened recently as a result of an injury then there is a scope for treatment and recovery by using a specific splinting regime to help encourage healing of the stretched or torn volar plate.
You’re going to need to use a splint which holds the PIP joint in a slightly bend position, and you’re going to need to wear it for about 8 weeks. What you're trying to do is keep the volar plate off stretch so it can heal in the correct position. The splinting regime is usually done under the supervision of a hand therapist.
 |
| A Suitable Splint (Product Link) |
If you’ve had swan neck deformity for a while, perhaps you’ve tried the splinting regime and its not worked or you have joint hypermobility or rheumatoid arthritis, then you can choose to use a splint for the long term. You don't need to wear it all the time, just when you're active with your hands, and this will help with finger function. It will stop any snapping or flicking of the finger and generally improve finger movement while you’re wearing it.
For most people with a long term swan neck the symptoms are usually mild and managable and so the best option is often to leave it alone. But if it is a real problem for you or if it's painful, then you might need to see a hand surgeon as there are a few different surgical options, depending on your individual situation.
_____________________________________________________________________________
This article provides general information related to various medical conditions and their treatment. It is intended for informational purposes only and not a substitute for professional advice, diagnosis or treatment provided by a doctor or other qualified health care professional. The information provided does not constitute personal advice or guarantee of outcome and should not be used to diagnose yourself or others. You should never ignore advice provided by a health care professional because of something you have seen or read on this website. You should always consult a doctor or other qualified health care professional for personal medical advice.