What is an Acquired Hand Deformity?
An acquired hand deformity develops after birth and changes how your hand looks or works. Unlike conditions you’re born with, these problems start because of injury, arthritis, nerve damage or other health issues.
Why Do They Happen?
Everyday wear-and-tear, sudden knocks or underlying diseases can all play a part. For example:
• A sports injury that jams your finger can tear a tendon.
• Rheumatoid arthritis makes your lining (synovium) swell and wear down joints.
• A trapped nerve (for example, in the neck) can leave parts of your hand weak or numb.
Common Types of Hand Deformities
• Boutonnière deformity – The middle finger joint bends down while the fingertip bends back. Often follows a “jammed” finger or arthritis.
• Mallet finger – The fingertip droops because the tendon that straightens it is injured.
• Swan-neck deformity – The middle joint straightens too far and the fingertip bends down, like a swan’s neck.
• Dupuytren’s contracture – Thickened tissue in the palm pulls one or more fingers into a bent position.
• Gamekeeper’s (Skier’s) thumb – Ligament damage at the base of the thumb makes pinching and gripping hard.
• Ulnar claw hand – Nerve damage causes the ring and little fingers to curl into a “claw” shape.
000How Might You Notice a Problem?
• Pain, swelling or redness around a joint
• Stiffness that makes gripping cups or opening jars tricky
• Fingers that look bent or twisted
• Weakness or numbness in part of the hand
• Difficulty straightening or bending one or more fingers
Getting the Right Diagnosis
Prof Imam or a therapist will:
• Ask about when it started and what you first noticed
• Examine how your fingers move and test your grip strength
• Perform simple tests, such as the Elson test for certain tendon injuries
• Take X-rays or an ultrasound to look at bones and soft tissue
• Use nerve studies (EMG) if numbness or weakness suggests a nerve problem
• Request blood tests if arthritis or gout is suspected
Treatment Options
Non-Surgical Care
• Splints and braces hold joints in the correct position while tissues heal
• Pain relief: paracetamol or anti-inflammatories (NSAIDs) help control discomfort
• Hand therapy: guided exercises keep nearby joints moving and build strength
• Injections: steroid shots reduce inflammation in certain arthritic conditions
Surgical Care
Prof Imam may recommend an operation if:
• A severe tear or bone fragment is causing ongoing pain or instability
• A tendon is completely severed and cannot heal on its own
• Long-standing deformity fails to improve with splints and therapy
Common procedures include tendon repair, ligament reconstruction or joint fusion (arthrodesis) to stabilise the finger.
Living with a Hand Deformity
• Use adapted tools (wide-handled pens, jar openers) to ease daily tasks
• Keep joints protected—avoid heavy gripping or sudden impacts
• Follow your hand therapist’s home-exercise programme to maintain flexibility
• Learn pacing techniques: break tasks into smaller steps and rest between them
• Attend regular check-ups so changes can be spotted and treated early
Frequently Asked Questions
How long will I wear a splint?
Most splints stay on 6–8 weeks, then may be worn at night for a few more weeks. Your therapist will adjust this to your healing.
Will therapy really help?
Yes. A tailored exercise plan prevents stiffness, keeps nearby joints moving and rebuilds hand strength.
Can the deformity come back?
Some conditions, such as Dupuytren’s contracture, can recur. Ongoing monitoring and early treatment help prevent severe changes.
When is surgery the best choice?
Surgery is usually a last resort—when splints and therapy don’t restore enough function or when an injury will not heal on its own.
Call to Action
For step-by-step exercise videos, printable guides and specialist referrals, visit www.TheArmDoc.co.uk/hand-therapies. To book an appointment with our hand clinic, call 020 3384 5588 or email Info@TheArmDoc.co.uk.
Evidence & Guidelines
• NICE CG79 – Rheumatoid arthritis: early diagnosis and management
• NICE CG177 – Osteoarthritis: assessment and non-surgical management
• British Society for Surgery of the Hand – Standards for tendon injury care
Disclaimer
This guide is for general information only and does not replace personal medical advice. Always discuss your specific situation and treatment choices with your healthcare team.