Digital splinting for acute closed bony mallet finger: A case series

Area of Science:

• Hand surgery
• Orthopedic surgery
• Traumatology

Background:

• Acute bony mallet finger injuries require effective treatment to restore function.
• Nonoperative management is a key consideration for these injuries.
• Assessing outcomes of conservative treatments is crucial for clinical decision-making.

Purpose of the Study:

• To evaluate the clinical, radiographic, and functional results of digital splinting for acute closed bony mallet finger injuries.
• To determine the efficacy of conservative treatment in achieving bone consolidation and functional recovery.

Main Methods:

• A Level IV case series involving 19 patients with acute bony mallet finger.
• Exclusion criteria included loss to follow-up, chronic injuries, open lesions, or unstable/irreducible distal interphalangeal (DIP) joint subluxations.
• Treatment involved volar splint immobilization of the DIP joint in extension for six weeks, with a minimum 12-month follow-up.

Main Results:

• The average patient age was 33.6 years, with the little finger being most affected.
• 84.2% of patients had fractures with articular fragments larger than one-third of the articular surface.
• All fractures achieved bone consolidation, with a mean DASH score of 4.3 ± 2.8 and high patient satisfaction.

Conclusions:

• Conservative digital splinting is a reasonable nonoperative option for acute bony mallet finger injuries treated within four weeks.
• Satisfactory outcomes were observed in fractures with larger articular fragments and mild, splint-reducible DIP joint subluxations.
• Findings are limited to a descriptive case series and do not apply to unstable or irreducible subluxations.