Wrist & Hand
Tendon Injury
Evidence: uncertain
Boyes Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Central Slip Injury (Boutonniere Deformity).
How to Perform
- Position: Examiner holds the patient's finger in extension at the PIP joint.
- Action: Ask the patient to flex the DIP joint.
Interpretation of Results
- Positive Test: The patient cannot flex the DIP joint.
- Why: If the central slip is intact, extending the PIP relaxes the lateral bands, allowing DIP flexion. If ruptured, the lateral bands tighten, preventing DIP flexion.
Clinical Context & Limitations
The Boyes Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Wrist & Hand region, combining the Boyes Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
