Abstract
Introduction: Boutonniere deformity of the thumb or Z thumb consists in a flexion of the metacarpophalangeal joint and a hyperextension of the interphalangeal joint. This deformity is typically associated with rheumatoid arthritis, although in pediatric age it is usually congenital. Material and method: We present a 15-year-old male who was diagnosed with boutonniere deformity of the thumb in a mild stage and was surgically treated by volar release of soft tissues and rerouting of the extensor pollicis longus tendon, according to the Iwamoto technique. Discussion and conclusion: For the correct treatment of this type of injury, it is essential to differentiate between a reducible deformity and a fixed one, as well as to assess the state of the joint with imaging tests. In early stages with reducible deformities, the treatment is based on reconstruction of the extensor apparatus. In more advanced phases, arthroplasty or arthrodesis should be used.
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