gms | German Medical Science

Clinical issue/s: Mallet finger due to fracture of the insertion of the extensor tendon is a common sport injury that affects all ages. There are usually two ways to go about it, surgery or conservative treatment.

Conservative treatment is a valid option, however a few tricks can improve the outcome.

The splint should be worn 9 weeks - if after the splint is taken away, extension lag between 5 to 8º persists, the patient should be fitted with a swan neck splint for 3 more weeks.

Clinical reasoning: A custom made splint is absolutely necessary, prefabricated splints do not fit well, they can not be modified. Written indication for splint use can improve splint usage and cleaning.

When there is edema, the splint should be controlled after one, and three weeks of usage and another splint should be done if adjustment of the old one is not possible.

Special care for DIP swelling should be considered - COBAN is very useful.

DIP with fragment fractures treated this way between 6/2017 and 6/2018 - 60.

55 healed without no extension lag after 12 weeks, 5 needed surgery.

Innovative, analytical or new approach: One of the mayor tricks that change the outcome is an approximation tape at the DIP level. This tape will help the little peace of the fracture to get as close as possible to the bone

Contribution to advancing HT practice: The idea that a custom made splint can make the difference.

The approximation tape at the DIP joint and how it is done helps the bone to get into place.

And the combination of the DIP splint and the Swan neck splint when an extension lag is present.