Assesment of conservative therapy for pediatric patients with acute mallet finger deformity

Turan Taş; Seyran Kılınç; Volkan Güneyli; Okay Bulut; Kansu Çilli; Eyüp Zengin

doi:10.7197/cmj.v37i2.5000079536

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Assesment of conservative therapy for pediatric patients with acute mallet finger deformity

Abstract

Objective: We evaluated the effectivity of conservative treatment for acute mallet finger deformity in hands of pediatric patients due to trauma in this study. Method: Between 2011-2013, 19 pediatric patients treated due to mallet finger deformity disturbance were reviewed retrospectively. The demographic data and the injury mechanisms of the patients were recorded. We obtained the X-ray films of the patients via PACS system. The classification was applied by the Doyle system. A standard conservative treatment protocol that maintained distal interphalangeal joint (DIP) at extension were applied to all patients. Finger splint was used during the first week for DIP extension. Then another splint that is arranged by also considering the finger diameter and made up of thermoplastic material was used to keep DIP in extension. After the treatment, the patients were clinically evaluated according to Crawford criteria. Results: 13 patients were male and 6 of them were female. 12 patients were Doyle type 1 and 7 of them were Doyle type 4a.The patients were among 9-16 ages. The mean age was 13.2. The fixation time in extension for Doyle type 1 patients was 4 weeks and was 5 weeks for the patients with Doyle type 4a. Exercise program was started fixation; splint was used one week more only at nights. Excellent results were obtained according to Crawford criteria. 2 patients experienced superficial skin problems which healed without any complication. The duration for achieving full range of motion was one week longer than the other children in three patients. Conclusion: Thermoplastic stent is an effective and easily applicable treatment method with high patient compliance for patients with acute type1 and type 4a mallet finger deformity due to trauma.

Keywords

Mallet finger, pediatric patient, conservative treatment, thermoplastic splint

References

1. Wang QC, Johnson BA. Fingertip injuries Am Fam Physician 2001; 63: 1961-6.
2. Simpson D, McQueen MM, Kumar P. Mallet deformity in sport J Hand Surg Br 2001; 26: 32- 3.
3. Wehbé MA, Schneider LH. Mallet fractures. J Bone Joint Surg Am 1984; 66: 658-69.
4. Schneider LH. Fractures of the distal interphalangeal joint. Hand Clin 1994; 10: 277-85.
5. Hart RG, Kleinert HE, Lyons K. The Kleinert modified dorsal finger splint for mallet finger fracture. Am J Emerg Med. 2005; 23: 145-8.
6. Maitra A, Dorani B. The conservative treatment of mallet finger with a simple splint: A case report. Arch Emerg Med 1993; 10: 244-8.
7. Kalainov DM, Hoepfner PE, Hartigan BJ, Carroll C 4th, Genuario J. Nonsurgical treatment of closed mallet finger fractures. J Hand Surg Am 2005; 30: 580-6.
8. Richards SD, Kumar G, Booth S, Naqui SZ, Murali SR. A model for the conservative management of mallet finger. J Hand Surg Br 2004; 29: 61-3.

9. Cheung JP, Fung B, Ip WY. Review on mallet finger treatment. Hand Surg 2012; 17: 439-47.
10. Lubahn JD. Mallet finger fractures: A comparison of open and closed technique. J Hand Surg Am 1989; 14: 394-6.
11. Stark HH, Gainor BJ, Ashworth CR, Operative treatment of intraarticular fractures of the dorsal aspect of the distal phalanx of digits. Zemel NP, Rickard TA J Bone Joint Surg Am 1987; 69: 892-6.
12. Bauze A, Bain GI. Internal suture for mallet finger fracture. J Hand Surg Br 1999; 24: 688-92.
13. Ulusoy GP, Karalezli N, Koçer U, Uysal A, Karaaslan O, Kankaya Y. Pull-in suture tecnique for the treatment of mallet finger. Plast Reconstr Surg 2006; 118: 696-702.
14. Crawford GP. The molded polythene splint for mallet finger deformities. J Hand Surg Am 1984; 9: 231-7.
15. Mauffrey C. Mallet Finger: A Review. The Internet Journal of Orthopedic Surgery 2005; 3: 1.
16. Jabłecki J, Syrko M. Zone 1 extensor tendon lesions: Current treatment methods and a review of literature. Ortop Traumatol Rehabil 2007; 9: 52-62.
17. Warren RA, Norris SH, Ferguson DG. Mallet finger: a trial of two splints. J Hand Surg Br 1988; 13: 151-3.
18. Schmidt B, Weinberg A, Friedrich H. [The mallet finger in children and adolescents]. Handchir Mikrochir Plast Chir 2008; 40: 149-52.
19. Foucher G, Binhamer P, Cange S, Lenoble E. Long-term results of splintage for mallet finger. Int Orthop 1996; 20: 129-31.
20. David M. Kalainov, Peter E. Hoepfner, Brian J. Hartigan, Charles Carroll, James Genuario Nonsurgical Treatment of Closed Mallet Finger Fractures,The Journal of Hand Surgery 2005; 30; 580-6.
21. Altan E, Alp NB, Baser R, Yalçın L.Soft-Tissue Mallet Injuries: A Comparison of Early and Delayed Treatment. J Hand Surg Am 2014; 39: 1982-5.
22. O’Brien LJ, Bailey MJ. Single blind, prospective, randomized controlled trial comparing dorsal aluminum and custom thermoplastic splints to stack splint for acute mallet finger. Arch Phys Med Rehabil 2011; 92: 191-8.

Details

Primary Language

Turkish

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Turan Taş

Seyran Kılınç

Volkan Güneyli

Okay Bulut

Kansu Çilli

Eyüp Zengin

Publication Date

July 1, 2015

Submission Date

November 27, 2014

Acceptance Date

-

Published in Issue

Year 2015 Volume: 37 Number: 2

DOI

https://doi.org/10.7197/cmj.v37i2.5000079536

IZ

https://izlik.org/JA78WT84WE

Cite

RIS / Bibtex

AMA

1.Taş T, Kılınç S, Güneyli V, Bulut O, Çilli K, Zengin E. Assesment of conservative therapy for pediatric patients with acute mallet finger deformity. CMJ. 2015;37(2):121-125. doi:10.7197/cmj.v37i2.5000079536