A 55-year-old diabetic man presents with progressive inability to extend the ring and little finger metacarpophalangeal joints, with flexion contractures at those joints but normal PIP and DIP extension. The pathology involves:

• A Dupuytren's contracture of the palmar fascia ✓
• B Flexor digitorum superficialis contracture
• C Boutonniere deformity from central slip rupture
• D Intrinsic-plus contracture

Explanation

Dupuytren's contracture involves fibromatous thickening and contracture of the palmar fascia (pretendinous bands, spiral cords, natatory ligaments), producing progressive flexion contracture of the MCP and, later, PIP joints. The ring and little fingers are most commonly affected. It is associated with diabetes mellitus, epilepsy, alcoholism, and northern European ancestry. The PIP and DIP joints retain active extension capability in early disease, distinguishing it from intrinsic-plus deformity where PIP is extended with passive MCP extension.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.