Derek and Hypermobility
Swan Neck Finger Deformity
His means of self-expression, Derek’s guitar was his best friend. They were rarely apart until Derek’s hypermobile Marfan fingers intervened and put a temporary stop to their relationship. But an operation on his swan neck pinkie and forefinger will see him reunited with his guitar soon. Read on ...
Derek developed swan neck deformity in his little finger and forefinger. This worsened over time and increasingly inhibited his guitar playing so that he ultimately had to give up.
What is Swan Neck Deformity?
Swan neck deformity is a hand deformity in which your fingers are bent abnormally. Your finger’s middle joint bends back more than usual. The tip of your finger is bent down. It typically develops due to unusual stress on the volar plate, which is the ligament around the middle joint of the finger, or the proximal interphalangeal (PIP) joint. The resulting shape looks similar to that of a swan’s neck, which is how the condition got its name.
For swan neck deformity to occur, there must be unusual stress on these ligaments. This causes the ligament to loosen, which then causes hyperextension of the PIP joint. This forms a shallow “V” shape from the metacarpophalangeal, or knuckle, joint.
Simultaneously, the joint at the tip, called the distal interphalangeal (DIP) joint, goes into flexion. The finger bends, causing the fingertip to point downward.
The bent fingers may make it difficult for a person with swan neck deformity to grasp objects or make a fist. A doctor may classify the limited motion as a disability, since the person has lost some fundamental function in the fingers and hand.
Swan neck deformity usually only affects your fingers. Your thumb isn’t affected, as it has one less joint than your fingers.
In Derek’s situation, the little finger and forefinger of his left hand were affected. Derek approached the London Bridge Clinic where the surgeon performed a volar tenodesis which involves opening the palm side of the fingers via a zig-zag incision and taking part of one of the finger bending tendons and using this as a tie to prevent over-straightening. Here is a link to the video of the operation which is not for the faint-hearted.
Derek will soon be reunited with his guitar.
