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------------------------------------------------ A client recently lost significant function in the dominant hand following an extensor tendon injury and presents with boutonniere deformity.

Which is the BEST immediate course of action for the OTR to take in response to this client's hand function and impairment?

A. Dorsal blocking hand splint
B. Splint PIP joint in full extension
C. Splint PIP in full palm flexion
D. Resting position hand splint

The OTR should immediately splint the PIP joint in full extension to maintain alignment and prevent further deformity in a client with boutonniere deformity. The correct answer is B. Splint PIP joint in full extension.

Explanation:

The goal of treatment is to regain full range of motion of the affected finger. Treatment options include both surgical and nonsurgical modalities. Splinting is a nonsurgical treatment and involves immobilizing the affected joint to allow for PIP flexion(straightening) to occur. Supple boutonniere deformity must always be treated by initial physical therapy. Surgical procedure with reconstruction of the extensor apparatus is satisfactory if the PIP joint is normal.

The best immediate course of action for an Occupational Therapist Registered (OTR) to take in response to a client presenting with a boutonniere deformity, which is a significant functional impairment, is B. Splint PIP joint in full extension. This approach will help maintain the proper alignment of the joint and prevent further deformity while the injury heals. It is critical to manage such deformities promptly to ensure optimal recovery and return of hand function.