Postoperative Guidelines after a

correction of Boutonniere
deformity
Postoperative Guidelines after a
correction of Swan Neck deformity

Maintain as much extension
as possible of the PIP jt
throughout the splitting and
exercise for 3-6 wks
postoperatively. Remove
splint only for exercise and
wound care.
Initiate early DIP flexion
exercises with the PIP jt
stabilize in extension to
maintain the length of the
oblique retinacular ligament.
Begin with Active or Assisted
PIP flexion/extension
exercises to by 10-14 days or
sooner. Stabilize MCP jt in
neutral during PIP
movements
Emphasize PIP extension and
DIP flexion during exercise

Maintain the PIP jt in 10 to
20deg or 20-30deg
Initiate AROME at PIP and
DIP jts several days to 10-40
days postoperatively
Perform DIP extension
exercises with the PIP jt
stabilized in slight flexion
Stabilize the DIP jt in neutral
during PIP ROM exercises
Emphasize PIP flexion and
DIP extension

Precautions after a Boutonniere
deformity correction
Precautions after a Swan Neck
deformity correction

Avoid hyperextension of the
DIP jt
Avoid resisted exercises and
stretching of the extensor
mechanism of the PIP jt for 6-
8 wks

Limit PIP extension of
exercise to avoid excessive
stretch to the volar aspect of
the capsule
Avoid extreme flexion of the
DIP jt