Boutonniere deformity management: which statement accurately describes the treatment approach?

Study for the NBCOT Hand Injuries and Intervention Test. Prepare with flashcards and multiple choice questions, each question offers hints and explanations. Get ready for success!

Multiple Choice

Boutonniere deformity management: which statement accurately describes the treatment approach?

Boutonniere deformity is from a tear of the central slip of the extensor tendon over the PIP, which lets the surrounding extensor mechanism pull the PIP into flexion while the DIP often remains extended. The treatment goal is to protect the central slip and allow healing by preventing PIP flexion. The standard approach is to immobilize the PIP in extension with a splint (often a PIP extension splint or stack splint) for several weeks. This unloading of the central slip reduces tension at the injured site and promotes proper realignment and healing of the mechanism. While the PIP is held in extension, the DIP is left free to move, and controlled DIP motion (such as isolated DIP flexion exercises) is encouraged to maintain DIP ROM and prevent stiffness. After healing, gradual supervised ROM and strengthening are started. Options that place the PIP in flexion would continue to deform the extensor mechanism and are not appropriate for initial management. A bulky glove provides no targeted immobilization or protection for the injury and does not support the healing process.

Boutonniere deformity is from a tear of the central slip of the extensor tendon over the PIP, which lets the surrounding extensor mechanism pull the PIP into flexion while the DIP often remains extended. The treatment goal is to protect the central slip and allow healing by preventing PIP flexion.

The standard approach is to immobilize the PIP in extension with a splint (often a PIP extension splint or stack splint) for several weeks. This unloading of the central slip reduces tension at the injured site and promotes proper realignment and healing of the mechanism. While the PIP is held in extension, the DIP is left free to move, and controlled DIP motion (such as isolated DIP flexion exercises) is encouraged to maintain DIP ROM and prevent stiffness. After healing, gradual supervised ROM and strengthening are started.

Options that place the PIP in flexion would continue to deform the extensor mechanism and are not appropriate for initial management. A bulky glove provides no targeted immobilization or protection for the injury and does not support the healing process.

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