Mallet Finger: Two Different Injuries.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Mallet injuries, encompassing tendinous and bony types, are frequently observed.
• Current treatment often involves a standardized 6-8 week extension splintage for both injury types.
• Evidence suggests distinct characteristics and injury mechanisms warranting differentiated management.

Purpose of the Study:

• To differentiate between tendinous and bony mallet injuries.
• To highlight the distinct epidemiological and clinical features of each injury type.
• To inform appropriate treatment strategies based on injury classification.

Main Methods:

• Comparative analysis of patient demographics, injury mechanisms, and clinical presentation.
• Radiological assessment of extensor lag in tendinous versus bony mallet injuries.
• Review of treatment outcomes based on injury type.

Main Results:

• Tendinous mallet injuries occur in older patients, typically from low-energy incidents, with a larger mean extensor lag (31°).
• Bony mallet injuries affect a younger demographic (mean age 40), result from high-energy trauma, are painful, and present with a smaller mean extensor lag (13°).
• Bony mallet fractures are characterized as extension compression, not avulsion, contraindicating extension splinting.

Conclusions:

• Tendinous and bony mallet injuries exhibit significant differences in etiology, presentation, and radiological findings.
• Standardized extension splintage may be suboptimal for bony mallet injuries.
• Tailored treatment approaches based on accurate diagnosis of tendinous versus bony mallet injuries are recommended.