Conservative versus Surgical Treatment in Management of Closed Mallet Finger:A Systematic Review and MetaAnalysis

Abstract

Abstract Background Several methods of treatment have been mentioned in management of closed mallet finger injury, as conservative methods using stack splint,dorsal aluminum splint or custom thermoplastic splint, or surgical procedures as direct pinning method, extention block technique or hook plate fixation, there is no consensus for the best method of treatment. Objectives to review and meta-analyze the outcomes of conservative versus surgical treatment in management of closed mallet finger injury and statistically compare between their results of pain, extensor lag, range of motion of distal inter-phalangeal joint. Materials and Methods The review will be restricted to randomized controlled trials (RCTs), clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of conservative versus surgical treatment in management of closed mallet finger, articles published in English. PRISMA flow chart 950 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, 150 articles were found. By applications of all inclusion and exclusion criteria, only 55 articles which met all inclusion criteria, 50 studies were systematically reviewed, and 5 randomized controlled trials were fit to undergo a meta-analysis, after conducting meta-analysis we found that P value for pain svore based on visual analogue score (VAS) was 1, extensor lag P value < 0.001, and range of motion P value <0.001. Conclusion No significant differences was found between the conservative and the surgical groups regarding the pain score, distal inter-phalangeal joint extensor lag, and distal inter-phalangeal joint range of motion in treatment of closed mallet finger.