Boutonniere Deformity: Before Your Surgery

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What is a boutonniere deformity?

Bent finger caused by a tendon tear

A boutonniere (say "boo-tuh-NEER") deformity is an injury to the tendon that runs over the middle joint of a finger. The injury causes the middle joint to bend down and the end joint to bend up. When you have this injury, you can't straighten your finger.

"Boutonniere" is French for "buttonhole." The injury often causes an opening in the tendon that looks like a buttonhole.

It can also be caused by rheumatoid arthritis, which causes pain, stiffness, and swelling in the joints.

Your doctor may try using a splint to see if the injury heals. If a splint doesn't work or there are other problems, your doctor will talk to you about surgery. Surgery involves making a cut in the skin over the joint and fixing the tendon.

You will probably be able to go home after the surgery. Your doctor may put a splint on your hand or finger after the surgery. If so, wear it exactly as directed. Do not remove it until your doctor says that you can.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take aspirin or some other blood thinner, be sure to talk to your doctor. He or she will tell you if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The surgery will take about 90 minutes.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, influenza [flu], or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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