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Long-term Stack splint immobilization for closed tendinous Mallet Finger.

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Summary

Conservative treatment for tendinous mallet finger using a 16-week orthosis protocol, including 12 weeks of full-time wear and 4 weeks of night wear, yields satisfying clinical and functional outcomes.

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Area of Science:

  • Orthopedic surgery
  • Hand surgery
  • Musculoskeletal rehabilitation

Background:

  • Closed tendinous mallet finger is typically treated non-operatively with distal interphalangeal joint (DIPJ) extension splinting for 6-8 weeks.
  • Treatment protocols vary regarding orthosis type, immobilization duration, and night wear.
  • This study evaluates a specific protocol: 12 weeks of full-time Stack splinting followed by 4 weeks of night orthosis for DIPJ extension.

Purpose of the Study:

  • To evaluate the clinical and functional outcomes of tendinous mallet finger treated with a prolonged conservative protocol.
  • To assess the efficacy of 16 weeks of orthotic management for tendinous mallet finger injuries.

Main Methods:

  • Retrospective review of 101 patients (100 cases) with tendinous mallet finger treated between March 2007 and December 2017.
  • Patients received 12 weeks of full-time Stack splinting and 4 weeks of night orthosis for DIPJ extension.
  • Outcomes measured included extension lag, DIP joint flexion angle, and clinical evaluation using Crawford and Abouna & Brown criteria.

Main Results:

  • Mean extension lag significantly reduced from 28.3 to 2.6 degrees (p<0.001).
  • Mean DIP joint flexion at final follow-up was 68.3 degrees.
  • Excellent or good results were achieved in 81% of patients (Crawford scale), and success or improvement in 85.5% (Abouna & Brown criteria).

Conclusions:

  • A prolonged orthosis regimen of 16 weeks (12 weeks full-time, 4 weeks night) is effective for treating tendinous mallet finger.
  • This extended conservative approach achieves satisfactory clinical and functional results.
  • The findings support the use of this specific splinting protocol for tendinous mallet finger injuries.