Boutonniere deformity - Revision history

ClaireLewis at 16:14, 18 October 2019

2019-10-18T16:14:41Z

← Older revision		Revision as of 16:14, 18 October 2019
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	*Elson’s test: bend PIP 90 deg over edge of table, extend middle phalanx against resistance. Should have weak PIP extension and DIP goes rigid as lateral bands have to work.		*Elson’s test: bend PIP 90 deg over edge of table, extend middle phalanx against resistance. Should have weak PIP extension and DIP goes rigid as lateral bands have to work.
	**Positive test indicated rupture of central tendon slip.		**Positive test indicated rupture of central tendon slip.
			*XR to assess for avulsion [[phalynx fracture\|fracture of middle phalanx]]

	==Management==		==Management==
	*XR to assess for avulsion fracture of middle phalanx
	*If open or with displaced avulsion fracture: operative repair		*If open or with displaced avulsion fracture: operative repair
	*Closed: splint in extension (Both DIP and PIP) for up to 6 weeks, refer to hand surgeon. NO flexion of DP permitted for duration of splinting, including during cleaning. Repair extensor tendon if injured.		*Closed: splint in extension (Both DIP and PIP) for up to 6 weeks, refer to hand surgeon. NO flexion of DP permitted for duration of splinting, including during cleaning. Repair extensor tendon if injured.

2019-09-28T18:54:41Z

Differential Diagnosis

← Older revision		Revision as of 18:54, 28 September 2019
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Rheumatoid ~~Arthritis~~		*[[Rheumatoid arthritis]]
	*Volar PIP dislocation		*Volar [[Proximal interphalangeal dislocation (finger)\|PIP dislocation]]
	*Flexion contracture of PIP joint		*Flexion contracture of PIP joint

2019-05-10T01:09:46Z

2018-10-07T22:49:07Z

Background

← Older revision		Revision as of 22:49, 7 October 2018
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	**Disruption of central tendon causes lateral bands to be displaced volarly, causing them to act like flexors		**Disruption of central tendon causes lateral bands to be displaced volarly, causing them to act like flexors
	*FDP still intact		*FDP still intact
			[[File:Boutonniere deformity.jpg\|thumb]]

	==Clinical Features==		==Clinical Features==

2017-07-13T06:27:31Z

← Older revision		Revision as of 06:27, 13 July 2017
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	==Evaluation==		==Evaluation==

	*Elson’s test: bend PIP 90 deg over edge of table, extend middle phalanx against resistance. Should have weak PIP extension and DIP goes rigid as lateral bands have to work.		*Elson’s test: bend PIP 90 deg over edge of table, extend middle phalanx against resistance. Should have weak PIP extension and DIP goes rigid as lateral bands have to work.
	**Positive test indicated rupture of central tendon slip.		**Positive test indicated rupture of central tendon slip.
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	*XR to assess for avulsion fracture of middle phalanx		*XR to assess for avulsion fracture of middle phalanx
	*If open or with displaced avulsion fracture: operative repair		*If open or with displaced avulsion fracture: operative repair
	*Closed: splint in extension (Both DIP and PIP) for up to 6 weeks, refer to hand surgeon. NO flexion of DP permitted for duration of splinting, including during cleaning. Repair extensor tendon if injured.		*Closed: splint in extension (Both DIP and PIP) for up to 6 weeks, refer to hand surgeon. NO flexion of DP permitted for duration of splinting, including during cleaning. Repair extensor tendon if injured.

	==Disposition==		==Disposition==
	*Hand specialist follow up if closed injury		*Hand specialist follow up if closed injury
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	==External Links==		==External Links==


	==References==		==References==


	<references/>		<references/>

	[[Category:Orthopedics]]		[[Category:Orthopedics]]

2017-04-18T14:06:08Z

Evaluation: minor edit

← Older revision		Revision as of 14:06, 18 April 2017
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	*Elson’s test: bend PIP 90 deg over edge of table, extend middle phalanx against resistance. Should have weak PIP extension and DIP goes rigid as lateral bands have to work.		*Elson’s test: bend PIP 90 deg over edge of table, extend middle phalanx against resistance. Should have weak PIP extension and DIP goes rigid as lateral bands have to work.
	**Positive test indicated rupture of central ~~tnedon~~ slip.		**Positive test indicated rupture of central tendon slip.

	==Management==		==Management==

2016-07-21T21:15:43Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 21:15, 21 July 2016
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	{{Hand and finger injury DDX}}		{{Hand and finger injury DDX}}

	==~~Diagnosis~~==		==Evaluation==

	*Elson’s test: bend PIP 90 deg over edge of table, extend middle phalanx against resistance. Should have weak PIP extension and DIP goes rigid as lateral bands have to work.		*Elson’s test: bend PIP 90 deg over edge of table, extend middle phalanx against resistance. Should have weak PIP extension and DIP goes rigid as lateral bands have to work.

2016-07-12T04:21:13Z

Text replacement - " w/ " to " with "

← Older revision		Revision as of 04:21, 12 July 2016
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	*Jamming		*Jamming
	*Laceration distal to PIP can injure central tendon		*Laceration distal to PIP can injure central tendon
	*On exam, will see hyperflexion of PIP w/ hyperextension of DIP and MP joints.		*On exam, will see hyperflexion of PIP with hyperextension of DIP and MP joints.

	==Differential Diagnosis==		==Differential Diagnosis==

2016-06-27T13:41:14Z

Text replacement - "*Rosen's" to ""

2016-06-26T03:38:02Z

Text replacement - "*Tintinalli" to ""