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Related Experiment Videos

Extensor tendon injuries at the distal interphalangeal joint

M A Brzezienski1, L H Schneider

  • 1Department of Orthopaedic Surgery, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

Hand Clinics
|August 1, 1995
PubMed
Summary

Nonoperative management, including 6- to 8-week splinting of the DIP joint, is the primary treatment for mallet finger injuries. Surgery, often involving a transarticular Kirschner wire, is reserved for failed conservative cases.

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Area of Science:

  • Orthopedics
  • Hand Surgery
  • Sports Medicine

Background:

  • Soft-tissue mallet finger injuries, both acute and chronic, present ongoing treatment controversies.
  • Nonoperative management is generally prioritized for these injuries.

Purpose of the Study:

  • To review and emphasize the efficacy of nonoperative management for mallet finger injuries.
  • To outline surgical options when conservative treatment fails.

Main Methods:

  • Nonoperative management involves 6- to 8-week uninterrupted external splinting of the distal interphalangeal (DIP) joint.
  • Surgical options include transarticular Kirschner wire placement or salvage procedures like central slip tenotomy.

Main Results:

  • Splinting is effective, safe, and reproducible for both acute and chronic mallet finger lesions.

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  • Nonoperative treatment can be delayed and remain effective, though the absolute time limit is unknown.
  • Surgery is considered for cases where conservative management fails after one or two attempts.

    • Conclusions:

    • Closed, nonoperative techniques are the mainstay for treating mallet finger injuries.
    • Early and consistent splinting of the DIP joint is crucial for successful outcomes.
    • Transarticular Kirschner wire fixation is a preferred surgical option for refractory cases.