Article
Mallet Finger Splinting – No Skin Irritation, No PIP Stiffness
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Authors
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Egemen Ayhan
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Orthopaedics and Traumatology - Hand Surgery, Ankara, Turkey
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Yakup Kuzucu
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Orthopaedics and Traumatology, Ankara, Turkey
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Emrah Efe Aslaner
- Baskent University, Adana, Turkey
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Zeynep Tuna
- Gazi University Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: Conservative treatment of mallet finger injury was reported to fail in some patients due to discontinuation of splinting especially because of skin complications within the splint. We thought that the complication rates would decrease with an appropriate patient education about splint use. Therefore, the aim of this study was to assess the complication rate and clinical results of conservative treatment of mallet finger with detailed instructions of splint use.
Methods: Fifty consecutive patients with mallet finger deformity were enrolled. They were instructed to wear the splint 7/24 hours for the first six weeks and advised to take it off once a day for 10 minutes for their skin to vent. They were strictly told to support the distal interphalangeal (DIP) joint during wear on and off. Besides, free proximal interphalangeal joint (PIP) movement was emphasized within the splint. Following six weeks 7/24 regime, night splinting continued for two more weeks. Patients were called for last follow-up and assessed for "Outcome Measures for Mallet Finger Injury" including pain, stiffness, range of motion (ROM), functional impairments and satisfaction.
Results and Conclusions: Thirty patients admitted for follow-up and the mean age was 37.1. Average follow-up duration was 6.4 (3-14) months. None of the patients gave up wearing the splint during the treatment period as no skin irritation was seen and PIP joints' ROM were not affected. Nine patients were injured on their 5th finger, 13 were on 4th and 8 were on 3rd finger. Ten of the patients had bony mallet injury. According to the applied criteria, 20 of the patients achieved at least three criteria. Extensor lag was less than 20° in 19 patients and flexion arc was more than 50° in almost all patients (n: 28). Most patients (n: 20) reported noticeable pain or stiffness in their finger and 14 patients had difficulty during heavy activities. Satisfaction level was at least 9/10 in 17 patients.
Detailed education about the splint use to prevent the patients' complaints resulted in satisfactory clinical results. It also improved the compliance with the splinting regime with no skin irritation or excessive stiffness of the finger. Therefore, the clinicians should spare some more time for patient education for its potential benefits like the decrease in the need for surgery after a well-applied splinting treatment.
