What deformity results from a central slip injury to the extensor mechanism, and how is it managed?

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Multiple Choice

What deformity results from a central slip injury to the extensor mechanism, and how is it managed?

Injury to the central slip disrupts the extensor mechanism at the PIP, letting the lateral bands shift volarly and convert the extensor pull into a deformity where the PIP sits in flexion while the DIP hyperextends—classic boutonnière deformity. The best management is to protect the healing central slip by immobilizing the PIP joint in extension, while allowing the DIP and other joints to move. After a period of immobilization, controlled motion is started to restore tendon glide and prevent stiffness. This approach directly protects the injured structure and addresses the deformity; immobilizing the DIP in flexion, immobilizing the MCP, or moving immediately through full ROM would not support healing.

Injury to the central slip disrupts the extensor mechanism at the PIP, letting the lateral bands shift volarly and convert the extensor pull into a deformity where the PIP sits in flexion while the DIP hyperextends—classic boutonnière deformity. The best management is to protect the healing central slip by immobilizing the PIP joint in extension, while allowing the DIP and other joints to move. After a period of immobilization, controlled motion is started to restore tendon glide and prevent stiffness. This approach directly protects the injured structure and addresses the deformity; immobilizing the DIP in flexion, immobilizing the MCP, or moving immediately through full ROM would not support healing.

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