Board of Certification for the Athletic Trainer (BOC) Practice Test

What is the MOST appropriate splinting position for a Boutonniere deformity?

1. Proximal and distal interphalangeal joints in extension

2. Proximal interphalangeal joint in flexion and distal interphalangeal joint in extension

3. Proximal and distal interphalangeal joints in flexion

4. Proximal interphalangeal joint in extension and distal interphalangeal joint in flexion

The correct answer is: Proximal and distal interphalangeal joints in extension

For a Boutonniere deformity, the most appropriate splinting position is to keep both the proximal interphalangeal joint and the distal interphalangeal joint in extension. This position is crucial because a Boutonniere deformity occurs when there is a rupture of the central slip of the extensor tendon, leading to synovitis and a characteristic bending of the middle joint of the finger while the fingertip and the base of the finger may extend or be straight. By splinting the joints in extension, it allows for proper alignment of the fingers, promotes healing of the damaged extensor tendon, and helps prevent further contracture or deformity. Maintaining the proximal interphalangeal joint in extension is essential to prevent the flexion that characterizes the deformity. Additionally, keeping the distal interphalangeal joint extended helps to stabilize the finger as a whole, aiding in the recovery process and improving function over time. This splinting position is integral to the rehabilitation strategy and aligns with best practices in the management of this specific injury.