20250819 Stiff fingers Dr Thivagar

When performing the Bunnell test, you note that there is more flexion of the PIPJ when the MCPJ is flexed. This indicates tightness of:

• A. Checkrein Ligaments

• B. Volar Plate

• C. Lumbricals

• D. Extensor Tendon

After releasing the checkrein ligaments for a PIPJ flexion contracture release,you note a persistent flexioncontracture. What do you do next?

• A. Release the accessory collateral ligament

• B. Release The collateral ligament

• C. Divide the A3 Pulley

• D. Sacrifice the flexor digitorum superficialis tendon

A 30 year old gentleman presents to you with the flexion contracture below. Active extension and passive extension range of movement  are similar. He is able to fully flex the ring finger

without pain. What is the most likely pathology?

• A. Intrinsic tightness

• B. Oblique Retinacular Ligament tightness

• C. Volar plate contracture

• D. Central Slip rupture

Which of the following statement is correct?

• A. Collateral ligaments are loose at MCPJ flexion, tighten during increasing extension.

• B. Volar plate helps prevent hyperflexion of MCPJ and PIPJ

• C. Lax collateral ligament can cause swan neck deformity

• D. Collateral ligaments are the main stabilizer to the abduction and adduction stress of MCPJ

Why is the metacarpophalangeal (MP) joint particularly affected during early post-injury edema?

• A. It has minimal capsular laxity in extension

• B. It is stabilized in flexion by intrinsic muscles

• C. Its intracapsular volume is maximal in extension, encouraging fluid accumulation

• D. It is structurally resistant to hydrostatic pressure