A 45-year-old man visits the outpatient clinic after a digit of his left hand was injured when a door was slammed on his hand. A superficial cut on his middle finger has been sutured, but functional deficits are observed in the finger: The proximal interphalangeal joint is pulled into constant flexion, whereas the distal interphalangeal joint is held in a position of hyperextension. What is the most likely diagnosis?
Correct Answer: Boutonniere deformity
Description: In boutonniere deformity, the central portion of the extensor tendon expansion is torn over the PIP joint, allowing the tendon to move palmarward, causing the tendon to act as a flexor of the PIP joint. This causes the DIP joint to be hyperextended. The tear in the extensor tendon is said to resemble a buttonhole ("boutonniere" in French), and the head of the proximal phalanx may stick through the hole.
Category:
Anatomy
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