Results of treatment of mallet finger by internal splinting - a preliminary report

Mallet finger, although common represents a spectrum of injuries for which there are many questions about the best form of treatment. Many authors advocate orthopedic treatment which is less invasive but requires greater patients dedication to implement. Despite a great number of different sort of orthosis none has proved superiority. The method of internal splinting of the DIP joint is less troublesome for the patient uniting the assets of orthopedic and surgical treatment. The goal of the study is the evaluation of the above mentioned method. Thirty three patients aged from 18 to 55 years (the same number of fingers) were treated by means of internal splinting of the DIP joint for mallet finger. Most of the lesions involved the middle finger (29 %), the lesion was mostly (54%) sustained during house-work; mean period from trauma to treatment was 3,8 weeks. The splinting was performed by means of 1-1,2 mm K wire, after applying Oberst's type of anesthesia. The stabilization was maintained for 8 weeks, then the patients were required to splint the joint for the period of 4 weeks. The mean period of follow-up was months. Twenty four patients (72%) were examined. One patient had a K-wire removed after 4 weeks due to infection and the treatment was continued according to the time protocol by means of Stack's orthosis. No other complications were observed. The total active flexion of the affected digit was similar to the unaffected counterpart. The mean lag of extension was 5,68 degrees ; 31/33 (91%) fingers were rated excellent and good acc. to Miller scheme. Internal splinting method of treatment of mallet finger is a recommendable alternative for other methods.