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Swan neck deformity has many of possible causes arising from the DIP, PIP, or even the MCP joints. In all cases, there is a stretching of the volar plate at the PIP joint to allow hyperextension, plus some damage to the attachment of the extensor tendon to the base of the distal phalanx that produces a hyperflexed mallet finger.
Additionally, swan-neck deformity can be caused by weakening or tearing of the ligament and tendon on the middle joint of a finger. [10] Other causes of swan-neck deformity include untreated mallet finger, muscle spasticity, physical hand trauma, and many others.
Surgery generally does not improve outcomes. [2] It may be required if the finger cannot be straightened by pushing on it or the break has pulled off more than 30% of the joint surface. [2] Surgery may be preferred over the use of a splint if a child is non-compliant. [5] If the problem has been present a long time surgery may also be required. [6]
738 Other acquired deformity. 738.0 Acquired deformity of nose; 738.1 Other acquired deformity of head; 738.2 Acquired deformity of neck; 738.3 Acquired deformity of chest and rib; 738.4 Acquired spondylolisthesis; 738.5 Other acquired deformity of back or spine; 738.6 Acquired deformity of pelvis; 738.7 Cauliflower ear; 738.8 Acquired ...
Craniofacial surgery is a surgical subspecialty that deals with congenital and acquired deformities of the head, skull, face, neck, jaws and associated structures. Although craniofacial treatment often involves manipulation of bone, craniofacial surgery is not tissue-specific; craniofacial surgeons deal with bone, skin, nerve, muscle, teeth, and other related anatomy.
In adjunct with surgery, refractory muscle contracture can also be treated with Botulinum toxins A and B; however, the effectiveness of the toxin is slowly lost over time, and most patients need a single treatment to correct muscle contracture over the first few weeks after surgery. [21] Shortening of the surgically lengthened muscle can re-occur.
Surgery can help alleviate skin contractures in the form of skin grafts and removal of hypertrophic scars. [ 8 ] [ 6 ] For hypertrophic scars, timing is important when considering surgery, as over time scars will mature and may show decreased contractures along with flattening, softening, and repigmentation without surgical intervention.
Indication for surgery: HE angle more than 60 degrees, progressive deformity, neck-shaft angle <90 degrees, development of Trendelenburg gait. Surgery: subtrochanteric valgus osteotomy with adequate internal rotation of distal fragment to correct anteversion; common complication is recurrence. If HE angle is reduced to 38 degrees, less evidence ...