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Occurs when the two interphalangeal joints point in unnatural directions and cannot straighten into a flat position.
Can cause pain, as well as limited use of fingers and hands.
The middle joint or the proximal interphalangeal (PIP) joint of the finger may hyperextend, or point upward.
The end joint of the finger, the distal interphalangeal (DIP) joint may also flex, or point downward.
SND does not involve the thumb.
Causes include:
rheumatoid arthritis (RA)
cerebral palsy
scleroderma
psoriatic arthritis
stroke
Parkinson’s disease
trauma to the hand
If the volar plate, a main ligament in the finger, becomes too loose it can lead to the PIP joint pointing upward, and causes the DIP joint to curve downward.
Rheumatoid arthritis can affect the volar plate because of the inflammation the condition causes.
Injury may cause joint damage or tightened muscles, leading to your fingers bending in the SND position.
The diagnosis is clinical and confirmed by X-rays.
Noninvasive treatments include physical therapy, occupational therapy and splints.
More invasive procedures include surgery that can range from minor soft tissue repair to replacing or fusing the finger joint.
Splints try to correct and stabilize the SND and is applied with physical and occupational therapy.
Splints may include the entire finger or a specific joint , such as with a ring splint.
Splints vary as to the hours they are worn daily and duration of use.
Splints may restrict all movement of the finger or allow for some mobility.
Soft tissue repair of skin, tendons, and ligaments near the middle joint of the finger, recommended for moderate-level SND,
Soft tissue repair is a type of surgery that focuses on the skin, tendons, and ligaments near the middle joint of the finger, and may be recommended for moderate-level SND.
A superficialis sling targets the volar plate to help restrain the middle joint of the finger from hyperextension while allowing for downward movement in the joint.
PIP joint arthroplasty, replacing the middle joint of the finger may be required
Finger joint fusion is most commonly done in the DIP joint.
After this surgery one is unable to move the joint but it will be straight.
Joint fusion of the PIP joint reduces pain in the affected finger joint.