HAND THERAPY TREATMENT

CENTRAL SLIP BOUTONNIÉRE TREATMENT SYDNEY

Conveniently located throughout Sydney.

No Referral Needed

If you’re injured or experiencing pain, discomfort, or limited movement with your upper limbs, anywhere from your fingers to your shoulders, you’ve come to the right place.

REFERRAL

•Within 24 hours
•Urgent care required

IMAGING

Suggestion: X-ray or Ultrasound

MANAGEMENT

•Thermoplastic waterproof orthoses
•6 weeks full time wear
•ROM of DIPJ in particular

WHAT IS A CENTRAL SLIP (BOUTONNIÉRE DEFORMITY)

To enable our fingers to straighten, multiple tendons must collaborate effectively. These tendons are located along the sides and the top of the finger. The tendon positioned at the top is known as the central slip, which connects to the middle bone of the finger.

Injuries to the central slip typically occur when the finger is forcefully bent, such as when struck by a ball or during a dislocation of the middle joint. Damage to the central slip tendon can lead to a fixed flexion deformity, resulting in an inability to completely straighten the finger, and increases the risk of developing a condition known as a boutonniere deformity.

COMMON SIGNS OR SYMPTOMS OF CENTRAL SLIP INJURY

If you’re experiencing pain or difficulty straightening the finger, you could be suffering from a central slip injury. Common symptoms include:

Fixed flexion deformity
Forced flexion injury to the finger, dislocation
Inability to straighten the finger
Pain and swelling around the middle joint of the finger
Flexion contracture or loss of movement

It is important to seek medical attention if you have any of the common hand injuries. Prompt evaluation and treatment can help to prevent complications and promote healing.

ASSESSMENT OF A CENTRAL SLIP (BOUTONNIÉRE DEFORMITY)

A central slip injury can be due to either a fracture at the base of the middle bone (avulsion) or from a tear in the fibres of the central slip itself (tendinous). You may need an x-ray to check if the bone is broken as well as the tendon being damaged. Your Hand Therapist, Physiotherapist or Occupational Therapist can organise an Xray referral for you. They will also assess your finger movement, swelling and pain in order to confirm the diagnosis.

HAND THERAPY & CENTRAL SLIP INJURY

Following thorough assessment and discussion regarding the details of your injury, the therapist at The Hands Physio will customise a splint to keep the middle joint of your finger straight. This allows the tendon or fracture to heal in the optimal position, and is required for a period of up to 6-8 weeks. This timeline is determined by your hand therapist and based on a number of factors including the specifics of your injury, the timescales of your injury along with your individual functional needs and goals.

Once your tendon or fracture has been assessed as healed enough to safely move through range, your therapist will provide you with an exercises program and advise on how to successfully and safely ween from your splint. Ongoing discussion regarding your functional goals will allow your therapist to provide you with a range of motion and strengthening program specifically tailored to your needs.

What happens if I don't get treatment for my central slip injury?

If you do not get treatment for a central slip injury, the middle joint of the finger will not be able to straighten without help and may stiffen into a boutonniere position. This deformity is more difficult to fix and requires a much longer period of immobilisation in a splint in order to correct the imbalance of the soft tissues. A central slip injury will not heal optimally on its own.

CENTRAL SLIP INJURY TREATMENT

How will treating my central slip injury impact my life on a day-to-day basis?

Our custom-made, water proof splints ensure we get the most comfortable fit for you throughout the healing phase of your rehab. They are also removable, and your hand therapist will discuss with you when it is safe for you to take your splint on and off. We appreciate the need for our patients to be able to continue to engage in meaningful activities such as work and sport and therefore can provide thorough education on what activities are safe to engage in.

We also provide custom-made guards and strategies to minimise your risk when returning to sport and activities that require heavier use of your injured hand.

Does It Require Surgery?

Rarely does Central Slip require surgery. In the rare occasion where surgery may be required, we will be able to advise you on whom the most appropriate surgeon is for you to see.

CENTRAL SLIP INJURY TREATMENT AT THE HANDS PHYSIO

See below the two treatment approaches for a patient who has central slip, fixed flexion Boutonniere deformity

Fig. 1 - Basic Treatment

An aluminium splint that holds the finger in extension but does not allow range of the finger tip and stretching of the lateral bands.

Fig. 2: The Hands Physio Treatment

A custom made, functional, light weight, water proof, thermoplastic barrel splint with the finger tip left free to mobilise and stretch the lateral bands and the ORL.

BOOK AN APPOINTMENT NOW

The Hands Physio provides assessment and treatment for all conditions relating to the upper limb, including mallet finger. Visit our highly qualified and friendly therapists today at a location convenient to you.

CHOOSING THE RIGHT THERAPIST FOR CENTRAL SLIP

At Action Rehab The Hands Physio, our Hand Therapists, Physiotherapists, and Occupational Therapists have extensive experience assessing and treating central slip injuries, fixed flexion deformities and Boutonniere deformity. We will take the time to assess and treat your central slip, fixed flexion Boutonniere deformity, and we will tailor a splinting and strengthening program to treat your injury. At Action Rehab The Hands Physio we treat hundreds of central slip injury patients every year, and a strengthening and stabilisation program can assist with symptoms of Central Slip injury. To make an appointment, enquire, or find your closest location call us on (02) 9743 4672 or schedule an appointment online.

CENTRAL SLIP FAQs

How is central slip caused?

Central slip injury, fixed flexion, Boutonniere deformity is caused by an avulsion or rupture of the central tendon in the finger. A forced bend or trauma to the finger can cause the Central slip to rupture.

How common is it?

Central Slip injury is very common in ball sports but can be misdiagnosed as a finger dislocation so proper assessment is required.

How long does it take to recover?

If Central Slip injury is treated early then it can be prevented from becoming a fixed flexion deformity. Splinting normally requires six weeks, then a range of motion and strengthening program can begin.

Will Central Slip require surgery?

Generally no. Surgery is a last resort but again it is important to be assessed early. In the rare cases where surgery is required your hand therapist at Action Rehab The Hands Physio can refer you to the appropriate surgeon to have your Central Slip repaired.

Will Central Slip injury go away if left untreated?

If left untreated a Central Slip injury can become a fixed flexion deformity which can then develop into a Boutonniere deformity that can be very difficult to treat. These conditions can be functionally limiting and may require corrective surgery.