Acute or flexible boutonniere deformity therapy

0 - 6 weeks:

The PIP joint may be pinned in extension, and the pin will be removed by the physician at six weeks.

Active and Passive Range of Motion exercises are initiated to the MCP and DIP joints.

A four point boutonniere splint is fabricated to hold the PIP joint in full extension and provide an extension block to the DIP joint.

6 weeks:

The pin is removed. The four point splint is continued.

8 weeks:

Active and Passive Range of Motion exercises are initiated hourly to the PIP joint.

Taping and/or dynamic splinting may be initiated as needed to increase passive flexion.

NOTE:

The initiation of Passive Range of Motion exercises and/or dynamic splinting may be postponed or discontinued if an extensor lag is greater than 20 degrees is present.

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