Boutonniere deformity is a zigzag posture of the finger due to complicated changes in the tendons on the back of the finger. The PIP (middle) joint bends forward and the DIP (end) joint bends backward. Boutonniere may develop after trauma, from inflammation as in rheumatoid arthritis, or from a prolonged bent posture of the PIP joint from Dupuytren contracture. Regardless of the cause, once it develops, this deformity is difficult to correct even with surgery.
These images are examples of boutonniere deformity resulting from Dupuytren contracture.
