Chronic boutonniere deformity--an anatomic reconstruction.

Restoration of motion and appearance of the chronic boutonniere deformity is often accomplished by splinting. If the deformity persists following appropriate splinting, and if a full passive range of motion of the proximal interphalangeal joint is present, surgery may be recommended. Thirteen patients had surgical reconstruction over a 10-year period, with satisfactory improvement in all but one. This operation involves release of the transverse retinacular ligaments and reconstruction of the damaged central slip by using the local joint capsule and synovium attached to the base of the proximal phalanx.