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Central Slip Avulsion and Pseudoboutonnière Deformities, Sports Medicine

Jeffrey P. Feden, MD, FACEP, CAQSM and Razib Khaund, MD Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Boutonnière deformity describes a characteristic flexion deformity of the proximal interphalangeal (PIP) joint and hyperextension deformity of the distal interphalangeal (DIP) joint ...

DIAGNOSIS

HISTORY

  • Always consider injury to the central slip when an athlete “jams” a finger or has a PIP joint dislocation reduced.

  • Knowledge of the mechanism of injury and/or direction of a PIP joint ...

TREATMENT

GENERAL MEASURES

  • Boutonnière deformity:

    • Strict immobilization of the PIP joint in continuous extension for 4 to 6 wk; nighttime splinting for another 2 to 3 wk 3,4,5[C]

    • Allow active and passive...

ONGOING CARE

The athlete’s sport and position will dictate his or her ability to participate with the injured finger immobilized. 

REFERENCES

1
Carruthers KH, Skie M, Jain M. Jam injuries of the finger: diagnosis and management of injuries to the interphalangeal joints across multiple sports and levels of experience. Sports Health...

ADDITIONAL READING

  • Aronowitz ER, Leddy JP. Closed tendon injuries of the hand and wrist in athletes. Clin Sports Med.  1998;17(3):449–467.

  • Hogan CJ, Nunley JA. Posttraumatic proximal interphalange...

CLINICAL PEARLS

  • Central slip injury may not be immediately recognized; careful history, examination, and suspicion are essential in addition to close follow-up.

  • An acutely injured PIP joint with dorsal...

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