Orthoteers homepage Advertise on Orthoteers
Orthoteers Junior Orthoteers Orthopaedic Biomechanics Orthopaedic World Literature Society Educational Resources Image Gallery About Orthoteers Orthoteers Members search

Rupture of the central slip of the extensor hood of the finger. A test for early diagnosis

ABSTRACT: Closed rupture of the middle slip of the extensor hood of a finger is easily missed until the late appearance of a buttonhole deformity. Early diagnosis gives the best chance of satisfactory treatment, but Boyes' test becomes positive only at a late stage. A new test is described in which, from a 90 degrees flexed position over the edge of a table, the patient tries to extend the proximal interphalangeal joint of the involved finger against resistance. The absence of extension force at the proximal joint and fixed extension at the distal joint are immediate signs of complete rupture of the central slip. The theoretical basis and the method of performing the test are discussed. END OF ABSTRACT

Closed rupture of the central slip of the extensor tendon hood of the finger can easily be missed at an initial examination, even when it is suspected. Later, a classic buttonhole deformity will develop, but by then correction is difficult. Early diagnosis is essential for successful treatment. Boyes (1970) described a test for the integrity of the central slip. If the proximal interphalangeal joint is held passively extended, it is then possible for the normal individual to flex the terminal interphalangeal joint in isolation. However, if the central slip has been ruptured, there is increasing difficulty in performing this action. Unfortunately this test only becomes positive when the proximal part of the ruptured central slip has retracted and become adherent to the surrounding tissues. The test which is described below becomes positive immediately after complete rupture of the central slip.



This is a preview of the site content. To view the full text for this site, you need to log in.
If you are having problems logging in, please refer to the login help page.


© 2005-2007 Orthoteers.co.uk - last updated by Len Funk on 05 April 2005Medical Merketing and SEO by Blue Medical 
Biomet supporting orthoteersThe British Orthopedic Association supporting OrthoteersOrthoteers is a non-profit educational resource. Click here for more details
About
Anatomy Atlas
Basic sciences
Classifications
Clinical Examination
Courses
Elbow
Extras
Foot and Ankle
FRCS(Tr&Orth) Exam
Glossary
Hand & Wrist
Help
Hip & Pelvis
Humerus
Imaging in Orthopaedics
Knee
Log Book
MCQ
News
Newsletters
Orthopaedic infections & Microbiology
Orthopaedic pathology
Paediatric orthopaedics
Perioperative issues
Rehabilitation
Shoulder
Spine
Statistics
Surgical approaches
Trauma
Home
Hide Menu