Abstract:
Objective Bony mallet fingers are generally treated with surgery, and there are few reports on conservative treatment. This study retrospectively analyzed the efficacy of the molded polythene splint for bony mallet finger deformities, providing guidance for clinical treatment.
Methods A retrospective analysis was conducted on 19 patients with distal phalangeal dorsal avulsion fractures resulting in bony mallet fingers treated with splint in Department of Orthopedic Trauma, Beijing Tsinghua Changgung Hospital from March 2015 to September 2021.As a comparison, 29 patients who underwent surgical treatment with Ishiguro′s technique during the same period were collected, and the fracture and joint reduction, active flexion and extension angle of affected finger joint, Dargan function evaluation, complication rate were compared between the two groups.
Results The average DIPJ extensor lag was 0 °~15 °(4.68 ± 5.00)° in the splinting group and 0 °~12 °(3.14 ± 4.16 )° in the surgical group. There was no significant difference between the two groups(P=0.32). Active flexion angle was 38 °~60 ° (50.42±6.73)° in the splinting group and 35 °~62 °(48.38±7.49)° in the surgical group. There was no significant difference between the two groups(P=0.34). The proportion of affected/healthy side range of motion was (0.74±0.14) in the splinting group and (0.76 ± 0.13) in the surgical group. There was no significant difference between the two groups(P=0.85). 10 were excellent and 9 were good in splinting group on dargan function evaluation and 17 cases were excellent, and 12 cases were good in the surgical group. There was no significant difference between the two groups(P=0.77). The incidence of complications was 47.3% in the splinting group and 44.8% in the surgical group. There was no significant difference between the two groups(P>0.05).
Conclusion The short-term effect of surgical treatment of bony mallet finger is equivalent to that of splinting, and the incidence of complications is the same, but once the complications of surgical treatment occur, they are more serious and may be permanent. Splinting needs to pay attention to the patient′s compliance in order to achieve better results. Conservative treatment still has therapeutic value for some appropriately selected patients.
Key words:
Bony mallet finger,
Surgical procedure, operative,
Splint treatment,
Ishiguro technique
Feiqi Lu, Ye Yuan, Chengli Li, Guman Duan, Jiuzheng Deng, Jianjin Zhu, Dawei He, Yongwei Pan. Comparative analysis of extension orthosis and extension pin block technique for bony mallet fingers[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2024, 19(03): 245-250.