Differential Diagnoses

Workup

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Media Gallery

Anatomy of the proximal interphalangeal joint. The central slip passes directly over the joint and inserts on the base of the middle phalanx. The lateral bands pass around the joint, combine with the retinacular ligaments, and unite to form the extensor tendon that attaches on the distal phalanx. Lateral motion is minimized by the collateral ligaments, and extension is limited to 0º by the thick volar plate.
Volar plate disruption with a stable, nondisplaced avulsion fracture of the middle phalanx.
Dorsal dislocation of the proximal interphalangeal joint.
Typical boutonniere deformity.
Extension block splint with the proximal interphalangeal joint at 30°.
Proximal interphalangeal joint that has been splinted in extension for the treatment of a central slip injury.
Dynamic spring extension splint for the treatment of a boutonniere finger deformity.

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Author

Thomas H Trojian, MD Professor of Family Medicine, Sports Medicine Fellowship Director, Department of Family Medicine, Associate Chief, Division of Sports Medicine, Drexel University College of Medicine; Lead Team Physician, Drexel Athletics

Thomas H Trojian, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, Society of Teachers of Family Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Giselle Aerni, MD Assistant Director, Sports Medicine Fellowship Program, Associate Director, Family Medicine Residency Program, York Hospital; Head Team Physician, Spring Grove Area High School; Team Physician, Gettysburg College; Head Team Physician, SkipJacks Hockey

Giselle Aerni, MD is a member of the following medical societies: American College of Sports Medicine, American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Melissa Mascaro, MD Fellow in Sports Medicine, University of Connecticut School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Sherwin SW Ho, MD Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago Division of the Biological Sciences, The Pritzker School of Medicine

Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, Arthroscopy Association of North America, Herodicus Society, American Orthopaedic Society for Sports Medicine

Disclosure: Received consulting fee from Biomet, Inc. for speaking and teaching; Received grant/research funds from Smith and Nephew for fellowship funding; Received grant/research funds from DJ Ortho for course funding; Received grant/research funds from Athletico Physical Therapy for course, research funding; Received royalty from Biomet, Inc. for consulting.

Additional Contributors

Leslie Milne, MD Assistant Clinical Instructor, Department of Emergency Medicine, Harvard University School of Medicine

Leslie Milne, MD is a member of the following medical societies: American College of Sports Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Michael E Robinson, MD Consulting Staff, Department of Orthopedics, Division of Primary Care Sports Medicine, Permanente Medical Group and Kaiser Hospital

Michael E Robinson, MD is a member of the following medical societies: American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

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