The buttonhole deformity can be caused by disruption or attenuation of the central slip of extensor expansion and volar migration of lateral band. It is characterized by flexion deformity at the proximal interphalangeal joint and hyperextension of the distal interphalangeal joint. Splinting or K-wire fixation method can be used for the fresh case. Several methods have been designed for the chronic or established case: anatomical repair, tendon transfer or graft, tenotomy, arthrodesis, and shortening of the central slip with flipping over the lateral band. We experienced 17 cases of buttonhole deformities treated by surgical method from September, 1981 to September, 1991. There were 9 men and 8 women. Average age at the time of operation was 25.5 years and average delay between the rupture and repair was 8.5 months. Average duration of follow up was 22 months. The causes of injury were laceration in 7, blunt injury in 6 and machine injury in 4 cases. Middle fingers were involved in 8, ring fingers in 6 and index fingers in 3 cases. We performed central tendon shortening in 11, tendon transfer or graft in 3 and arthrodesis in 3 cases. Average active range of motion was improved markedly: 54° of flexion contracture in PIP joint and ° of hyperextension contracture in DIP joint were improved to 14° and 7 respectively. Comparing central tendon shortening with tendon transfer or graft in PIP joint, 51° of flexion contracture in central tendon shortening and 63° in tendon transfer or graft were improved to 11° and 25° respectively. According to the modified Soutter's functional criteria, the results were excellent or good in 82% of central tendon shortening and 67% of tendon transfer or graft. Satisfactory results were obtained with both plication and tendon graft procedures. But central tendon shortening with release of lateral bands was more appealing.