Approach to mallet finger injury: Practical guide for Canadian primary care physicians.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Primary Care Practice

Background:

• Mallet finger injuries result from extensor tendon avulsion from the distal phalanx, potentially with fractures.
• Delayed or untreated injuries can lead to chronic deformities like swan-neck, impairing hand function.

Purpose of the Study:

• To equip primary care physicians with an evidence-based framework for recognizing and managing mallet finger injuries.
• To enhance diagnostic confidence and treatment initiation for mallet finger injuries in primary care settings.

Main Methods:

• A comprehensive literature search was performed using PubMed and Google Scholar.
• Recommendations were classified using a 3-level system based on clinical evidence and expert opinion.

Main Results:

• Clinical diagnosis is key; X-rays assess fractures and joint alignment.
• Standard care involves 6-8 weeks of continuous splinting, yielding excellent results, even for delayed cases.
• Surgical referral is indicated for joint subluxation, open injuries, or failed conservative treatment.

Conclusions:

• Mallet finger injuries are manageable in primary care, leading to superior patient outcomes without specialist intervention.
• This review empowers primary care physicians to confidently diagnose, treat with splinting, educate patients, and identify surgical referral needs.