Evaluation of clinical outcome of acute mallet finger deformity managed conservatively in pediatric patients

Abstract

SUMMARY Objective: In this study, it was evaluated effectiveness of the conservatively treatment in the pediatric patients managed acute mallet finger deformity in the result of trauma. Method: Between 2011-2013, 19 pediatric patients treated due to mallet finger deformity disturbance were reviewed retrospectively. The demographic knowledges and the injuried mechanisms of the patients were inscribed. It was reached to the grafies of the patients via pacs system. The classification was applied in addition to Doyle system. All the patients were performanced for standart conservative treatment protocohol by keeping them in distal interphalangeal joint (DIP) extansion. The first one week it was followed by finger atel which keeps in DIP joint extension. After that, by splinting keeping the DIP joint in extension and also the thermoplastic supply prepared in addition to finger shape of the patient After the treatment, the patients were clinically evaluated in addition to Crawford criteria. Results: 13 patients were male and 6 of them were female. The 12 patients were Doyle type 1 and the 7 of them were Doyle type 4a.The patients were among 9-16 ages. The mean age was 13.2. The fixing time in extension for Doyle type 1 patients was 4 weeks and the patients Doyle type 4a was 5 weeks. It was started exercises to the patients after the fixing being finished; splint was used one week more only at nights. It was attained a perfect result for all the patients in additon to Crawford criteria. For 2 patients, the surficial skin problem owing to splint recovered without problem. The necessary duration for another 3 patients was one week longer than that of the other patients for getting exact range of motion. Conclusion: Thermoplastic splint easily applied and highly adapted by the patient is and effective treatment way for the instant patients devoloping owing to trauma acute type1 and type 4a mallet finger deformity. Keywords: Mallet finger, pediatric patient, conservative treatment, thermoplastic splint OZET Amac: Bu calismada, travma sonucu elde akut cekic parmak deformitesi gelisen cocuk hastalarda konservatif tedavinin etkinligi degerlendirildi. Yontem: Cekic parmak deformitesi nedeniyle 2011-2013 yillari arasinda tedavi edilen 19 cocuk hasta retrospektif olarak incelendi. Hastalarin demografik bilgileri, yaralanma mekanizmalari kaydedildi. Hastalarin grafilerine pacs sisteminden ulasildi. Siniflandirma Doyle sistemine gore yapildi. Tum hastalara distal interfalangeal eklemi ekstansiyonda tutan standart konservatif tedavi protokolu uygulandi. Ilk hafta distal interfalangeal (DIP) eklemi ekstansiyonda tutan parmak ateli ile takip yapildi. Sonrasin da ise hastanin parmak capina gore thermoplastik malzemeden hazirlanan yine DIP eklemi ekstansiyonda tutan splint kullanildi. Tedavi sonrasinda hastalar klinik olarak Crawford olcutlerine gore degerlendirildi. Bulgular: Hastalarin 13 tanesi erkek, 6 tanesi kadin idi. Hastalarin 12 tanesi Doyle Tip I, 7 tanesi Doyle Tip IVa idi. Hastalar 9-16 yas arasinda idi. Ortalama yas 13,2 idi. Ekstansiyonda tespit suresi Doyle Tip 1 hastalarda 4 hafta, Doyle Tip 4a hastalar da ise 5 hafta idi. Tespit sonlandirildiktan sonra hastalara egzersizler baslandi, splint 1 hafta daha gece kullanildi. Crawford olcutlerine gore tum hastalarda mukemme sonuc elde edildi. 2 hastada splinte bagli gelisen yuzeyel cilt problemi sorunsuz sekilde iyilesti. 3 hastada tam hareket acikligi kazanimi icin gereken sure diger hastalara gore 1 hafta daha uzundu. Sonuc: Travma sonucu gelisen akut Tip 1 ve Tip 4a cekic parmak deformitesi olan cocuk hastalarda thermoplastik splint kolay uygulanabilen, hasta uyumunun yuksek oldugu, etkin bir tedavi yontemidir. Anahtar sozcukler: Cekic parmak , cocuk hasta, konservatif tedavi, thermoplastik splint