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Hand & Upper Limb
intermediate
X-Type

Boutonniere Deformity

Tendon Injuries

A 35-year-old carpenter presents 4 weeks after jamming his middle finger. He initially thought it was just bruised but now notices progressive flexion of the PIP joint with hyperextension at the DIP joint. Examination reveals inability to actively extend the PIP joint against resistance while the DIP is held in flexion (positive Elson test). Regarding boutonniere deformity:

Mark each as TRUE or FALSE

A

Boutonniere deformity results from disruption of the central slip of the extensor mechanism at its i...

B

The "buttonhole" (boutonniere) refers to the proximal phalanx head herniating through the split betw...

C

The deformity occurs immediately after injury; lateral bands migrate dorsally; the terminal slip is ...

D

The Elson test detects central slip injury: with PIP flexed 90 degrees over table edge, asking patie...

E

Acute closed injuries with supple joints are treated with PIP extension splinting (6-8 weeks) allowi...

Answer the questions to see explanations

Click T (True) or F (False) for each option