The Swan Neck Deformities Overview
Swan neck deformities occur through extrinsic, and artucular abnormal anatomical factors. The swan neck deformities causes include: rheumatologic disease, extensor terminal tendon injuries, spastic conditions,injuries that cause volar plate laxity, fractures to the middle phalanx that heal in hyperxtension, and generalizedligamentous laxity. The swan neck deformity may also occur secondary to surgical procedures such as a flexor digitorum profundus (FDP) graft where the flexor digitorum superficialis(FDS) is absent.
The deformity is one in which function decreases as the proximal interphalangeal (PIP) joins loses its flexibility. The lateral bans become dorsally displaced and tension to extend the distal interphalangeal (DIP) join is reduced. The swan neck deformity treatment depends upon the etiologyic status on the PIP joint and its related anatomic structure. Classifisation of the deformity may help determine treatment method. Four classification have been described as follows: (1) PIP flexion remains supple in allpositions,(2) PIP flexion is limited by intrinsic tightness, (3) PIP flexion is limited in allpositions by articular factors and the joint remains good radiographically,(4) PIP flexion is limited in all positions by intra-articular factors as neted radiographically. Successful treatment of swan neck deformities are dependent upon careful examination and determination of contributing factors. The swan neck deformity in which the PIP joint is hyperextended and the DIP joint is flexed.
Surgical Purpose Of Swan Neck Deformities
To prevent hyperextension posture of the PIP joint with accompanying flextion of the DIP joint. The swan neck deformities nonoperative splinting may be used temporarily to restore extensor tendon balance and toprevent fixed contractures. Surgical correction may by obtained. Such transfers for active dynamic restoration of this balance. Such transfers may involve using the superficialis tendons or a wrist extensor prolonged with tendon grafts into the extensor mechanism. The passive restoration of balance includes atenodesis of the PIP joint using local tendons or using a tendons or using a tendon graft to bridge the PIPjoint.
Swan Neck Deformities Treatment Goals
The swan neck deformities treatment goals with nonoperative ; Promote balance of the extensor mechanism. Reduce intrinsic tightness. Maximize joint range of motion (ROM). Maintain ROM of wrist and uninvolved digits.
The swan neck deformities treatment goals with postoperative ; Promote wound healing. Control edema. Control scar formation. Prevent attenuation or rupture of surgical procedure. Limit PIP extension and encourage fult DIP extension. Promote full active flexion. Maintain ROM of ininvolved digits.
Swan Neck Deformities Nonoperative Indications /Precautions For Therapy
Indications ; Supple deformities where prevention of PIP hyprrextension restores DIP extension. Precautions ; Volar plate laxity, Intrinsic tightness, Dynamic imbalance originating at orher joints or due to systemic or neurologic condtions.
The swan neck deformity nonoperative therapy are active and passive joint rom, intrinsic stretch exercises, the swan neck deformity splint to balance finger extension joint extension.
The Swan Neck Deformity Postoperative Indications / Precautions For Therapy
Indications ; Following surgical procedures disigned to relieve the swan neck deformity
Precautions ; excessive exercise that could cause attenuation or rupture of tenodesis procedures, procedures that involve joint fusions, procedures involving joint arthroplasty, surgical treatment requiring capsulectomy, surgical treatment requiring tenolysis, procedure for swan neck deformities requiring intrinsic release or metacarpophalangea (mcp) joint surgical treatment.