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Review Question - QID 7448

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QID 7448 (Type "7448" in App Search)
A boutonniere deformity is treated with distal extensor tenotomy. What structures allow for active extension at the distal interphalangeal (DIP) joint after tenotomy?

Lateral bands

38%

398/1035

Sagittal bands

13%

132/1035

Central slip

15%

153/1035

Oblique retinacular ligament

27%

283/1035

A healed but lengthened terminal extensor tendon

5%

50/1035

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Hyperextension of the DIP joint from a boutonniere deformity can be treated by the Dolphin tenotomy that divides the terminal extensor mechanism. Near normal extension of the DIP joint is the result of the intact oblique retinacular ligament of Landsmeer. Lateral bands are at the level of the proximal interphalangeal (PIP) joint. Sagittal bands are at the level of the metacarpophalangeal joint and are responsible for maintaining centralization of the extensor tendon at that level. The central slip extends the PIP joint. The corrective effect is immediate and is not determined by a healed extensor tendon at that level.

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