Orthopedics · Hand Surgery and Brachial Plexus Reconstruction

The intrinsic-plus position (the 'safe position') recommended for splinting the hand after burns or trauma is:

  • A MCP joints 70–90° flexion, IP joints full extension, thumb palmar abduction
  • B MCP joints extended, IP joints flexed, thumb abducted
  • C All joints at 90° flexion with thumb in opposition
  • D MCP joints 30° flexion, PIP joints 45° flexion, DIP extended
Correct answer: A. MCP joints 70–90° flexion, IP joints full extension, thumb palmar abduction

Explanation

The intrinsic-plus (safe) position places MCP joints at 70–90° flexion (tautening the collateral ligaments, preventing collateral shortening) and IP joints in full extension (stretching the volar plate, preventing flexion contracture). The thumb is held in palmar abduction to maintain the first web space. Splinting in MCP extension leads to collateral ligament shortening and a stiff claw deformity.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.

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