Swan Neck Deformity Correction

⚙️What This Procedure Involves

Multiple techniques exist depending on the cause and flexibility. Flexor digitorum superficialis (FDS) tenodesis: a slip of the FDS tendon is rerouted to act as a checkrein, preventing PIP hyperextension. Spiral oblique retinacular ligament reconstruction (SORL): restores the link between PIP flexion and DIP extension. Volar plate advancement: tightens the volar plate to prevent hyperextension. Dermadesis: a wedge of skin is removed from the volar PIP crease (for mild cases). The operation takes 30–60 minutes per finger.

💡Why It May Be Recommended

Surgery is recommended when the deformity limits hand function — particularly if the finger cannot initiate flexion from the hyperextended position, or if the deformity is progressing.

⚖️Non-Operative Alternatives

Ring splints (Silver Ring or Oval-8) that block PIP hyperextension while allowing flexion, hand therapy, and treatment of the underlying cause (rheumatoid disease control).

📋Preparing for Surgery

Assessment of deformity flexibility — the correction technique depends on whether the PIP joint is passively flexible or fixed. X-rays. Hand therapy assessment.

✅Expected Benefits

Restoration of a functional flexion arc. Prevention of the PIP joint locking in hyperextension. Results depend on the underlying cause and the flexibility of the deformity.

⚠️Common Risks

• RecurrenceCommon

  The deformity may recur, particularly in rheumatoid arthritis.

• StiffnessCommon

  Some loss of PIP extension.

• Over-correctionUncommon

  The PIP joint may develop a flexion contracture.

🔴Less Common but Serious Risks

• Tendon complicationsUncommon

  FDS tenodesis may cause triggering or bowstringing.

• InfectionRare

  Wound infection.

• Neurovascular injuryRare

  Digital nerve damage.

💉Anaesthetic Considerations

Local digital block, regional, or general anaesthesia.

🏃Recovery and Rehabilitation

Splinting for four to six weeks. Hand therapy for controlled exercises. Ring splints may be used long-term. Full recovery three to six months.

📅Follow-Up

Reviews with hand therapy at two weeks, six weeks, and three months.

❓Frequently Asked Questions