College of Massage Therapists of British Columbia (CMTBC) Practice Exam

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What is a Boutonnière deformity caused by?

Weakness in the flexor muscles
Rupture in the central tendinous slip of the extensor hood
Ligament strain in the PIP joint
Excessive use of the fingers

The correct answer is: Rupture in the central tendinous slip of the extensor hood

A Boutonnière deformity is primarily caused by a rupture in the central tendinous slip of the extensor hood. This condition typically involves the middle joint (PIP joint) of a finger being flexed while the fingertip is hyperextended. The central slip is crucial for the proper functioning of the extensor mechanism, and when it is disrupted, it leads to the characteristic positioning of the finger associated with this deformity. In the context of the deformity, the extensor tendon’s ability to extend the PIP joint is compromised due to the rupture, which results in the specific flexed position of the PIP joint and hyperextension of the distal joint (DIP joint). This mechanism distinguishes the Boutonnière deformity from other conditions that might affect the fingers. Weakness in the flexor muscles, ligament strain in the PIP joint, and excessive use of the fingers can influence hand function and may result in other hand pathologies but are not the direct causes of Boutonnière deformity. The underlying issue with the central tendinous slip and its role in finger extension is what makes this option the correct one.