Mallet Finger Deformity Research Articles

A Novel Prolene Suture Pull-out Technique Combined with Anchor Technique for the Treatment of Tendinous Mallet Finger.

Mallet finger deformity is a prevalent disability that causes discomfort and inconvenience to the patients. Despite the existence of various surgical approaches, surgical management remains a controversial subject. We retrospectively analyzed the clinical data of 26 patients with isolated tendinous mallet fingers who were admitted between January 2021 and June 2022. Among them, there were 18 men and eight women, aged between 20 and 56 years, with an average age of 38 years. The causes of injury were cutting injuries (15 cases), sports impact injuries (nine cases), and sprains (two cases). The time interval between injury and surgery ranged from 2 hours to 48 days, with an average of 12 days. During the surgical procedure, the distal interphalangeal joint was fixed in a mild dorsiflexion position using Kirschner wire. Absorbable anchors were used to assist in the reconstruction of the insertion point of the finger extensor tendon. Additionally, a 4-0 Prolene suture was used for reinforcement. All 26 patients were followed up for a period ranging from 6 to 24 months, with an average follow-up duration of 9 months. The function of distal interphalangeal joint was preserved. According to the Crawford functional evaluation criteria, the function of the affected fingers was excellent in 15 cases, good in eight cases, fair in three cases, and poor in no cases. A novel Prolene suture pull-out technique is an effective approach to repair tendon mallet finger and reconstruct the tendon-bone anatomical unit. This treatment option provides favorable outcomes, with high rates of excellent and good functional results.

Surgical Treatment of the Bony Mallet Injuries with Augmented Extension Block Technique: Clinical Outcomes of a New Modification

Surgical Treatment of The Bony Mallet Deformity with Augmented Extension Block Technique: Clinical Outcomes of a New Modification Introduction: Mallet finger deformity is a common pathology and the ‘Extension Block Technique’, is one of the most popular surgical techniques for the treatment of this condition. However, several complications may occur with this method such as fixation failure, compression failure of the dorsal part and loss of reduction. In the current study, it is aimed to report the result of our modification which is augmented extension block technique. Materials & Method: The medical records of patients, who were operated with the diagnosis of bony mallet finger between 2015 and 2021, were evaluated retrospectively. Demographic data, mechanism of trauma, duration of operation, time from injury to surgery, follow-up period, implant removal time, and postoperative complications were collected from hospital records. Patients aged between 18 - 65 years who had been operated with augmented extension block technique with a minimum follow-up period of 6 months were included in the study. A total of 10 patients who met these criteria constituted the study group. Radiological evaluation of the cases was performed with anteroposterior and lateral radiographs. Range of motion and presence of pain were questioned and these data were evaluated according to Crawford criteria. Results: The mean age of the all patients was 40.2 ± 10.9 (range, 24-56) years. The mean follow-up period was 39.6 ± 26.7 (range, 13-76) months. Complete union was achieved in all patients on the final follow-up radiographs. According to Crawford evaluation criteria, the results were ‘excellent’ in six of the patients and ‘good’ in four of them. There were no patients with loss of flexion however, 5° extension loss was observed in four of the subjects. Discussion: This study demonstrates that the augmented extension block technique is a suitable option for the surgical treatment of bony mallet cases with lower complication rate and successful functional results. This modification can be considered as an alternative option for traditional extension block technique which avoids some related complications as postoperative reduction loss, rotational instability and extension loss. Keywords: Mallet finger, Bony mallet, Extension Block

Current concepts in traumatic mallet finger management

Mallet finger deformities can be divided into tendinous deformities caused by tendon rupture and bony deformities caused by fracture. In many cases, conservative treatment is possible. The goal of treating traumatic mallet finger deformities is to accurately restore the ruptured tendon or fractured bone to its proper position, correct extension lag or flexion contracture, prevent joint arthritis, and restore the full range of motion through appropriate range of motion exercises at the right time. In cases of tendinous mallet finger, immobilization with a splint or cast for at least 6 weeks in the extended position is required. During this period, flexion at the distal interphalangeal joint should be strictly limited, while movement at the proximal interphalangeal joint is allowed. Patient compliance with the protocol is essential for achieving good treatment outcomes. If conservative treatment fails or if the deformity recurs after initial surgery, satisfactory results can be achieved through tenodermodesis surgery. If the bony mallet finger involves a bone fragment of 3 mm or more or subluxation of the distal phalanx, surgical treatment is recommended. The primary surgical treatment involves closed reduction and percutaneous pinning with the extension block technique.

Treatment of chronic mallet finger with swan neck deformity using a modified Spiral Oblique Retinacular Ligament (SORL) reconstruction procedure: A case series and technical note.

Chronic terminal extensor tendon injury produces mallet deformity and secondary swan neck deformity. It can be found in neglect cases and in a failed cases after conservative treatment or primary surgical repair. Surgery is considered in cases with extensor lag of more than 30° and functional deficit. Reconstruction of the spiral oblique retinacular ligament (SORL) has been reported in literatures to correct swan neck deformity by a dynamic mechanical basis. Three cases of chronic mallet finger associated with swan neck deformity were treated by the modified technique of SORL reconstruction. Range of motion (ROM) of distal interphalangeal (DIP) joints and proximal interphalangeal (PIP) joints were measured along with the complications. The clinical outcome was reported using the Crawford's criteria. All patients had an average age of 34years (20-54). Average time to surgery was 16.67months (2-24) and average of DIP extension lag was 66.67°. All patient gave excellent Crawford criteria at the latest follow up (average 15.3months). The average PIP joint ROM were -1.60 (00 to -50) of extension and 1100 (1000-1200) of flexion for the PIP joint and -1.60 (00 to -50) of extension and 83.330 (800-850) of flexion for the DIP joint. We present our technique to manage chronic mallet injury which only utilized two skin incisions and one button at the distal phalanx to minimize risk of skin necrosis and patient discomfort. This procedure can be considered as one of the options for the treatment of chronic mallet finger deformity associated with swan neck deformity.

Efficacy of Tenodermodesis Method in Chronic Mallet Finger Surgery

Objective: To report the efficacy of tenodermodesis surgery on a chronic mallet finger injury.
 Background: Mallet finger is an injury commonly emerging due to a partial or complete rupture of the extensor tendon's terminal insertion distal to the distal interphalangeal (DIP) joint. Commonly caused by a forced flexion of the DIP joint. 
 Material-Method: A total of 15 patients data was investigated retrospectively. All the patients whose conservative treatment failed and underwent a mallet finger surgery with the tenodermodesis method were included. The technic was slightly modified: Sutures were applied, so they traverse the skin and tendon together after suturing the tendon and capsule.
 Results: The patients were followed up for up to 24 months. All patients had improvements in DIP joint motion. Nine patients reached a full extension of the DIP joint. According to Crawford's criteria, all the patients have no pain and had an excellent and good score after the procedure. No postop complication was reported. 
 Conclusion: Tenodermodesis method a curative surgery technic with a high success outcome rate for chronic tendinous mallet finger deformity.

Evaluation of tautening method in repair of advanced mallet finger without bone fracture

Many different repair methods have been described in the frequently seen mallet finger deformity, but without consensus. The present study aimed to present an alternative tautening technique in mallet finger repair and to compare it versus classical direct repair. Patients with untreated chronic mallet finger of more than three months’ progression, treated surgically between March 2017 and October 2020, were included. Two surgical methods were applied to restore extensor function of the distal interphalangeal joints. In the first group, the granulation tissue was excised and the extensor tendon was repaired directly. In the second group, granulation tissue was not excised, and the extensor tendon was tautened by plication. Outcomes were evaluated according to Miller’s criteria. Fort-six patients were included: group 1, 25 patients; group 2, 21 patients. Mean age in group 1 was 36.2 years and 33.4 years in group 2. Mean follow-up in group 1 was 14.8 months and 13.9 in group 2. Extensor lag was similar (5.6°) in both groups at the end of the sixth month. On Miller’s mallet finger criteria, group 1 scored 3.4 points and group 2 3.4 points (p > 0.05). The tendon tautening method helps to start physiotherapy early, the learning curve is short, and it provides functionally positive results and a low complications rate. We think that this method should be evaluated in chronic mallet finger deformities without bone fracture.

The treatment of Doyle types II and III mallet finger with the encircling fixation of a transplanted palmaris longus tendon

ObjectiveThis study aimed to investigate the clinical effect of the encircling fixation of a transplanted palmaris longus tendon in the treatment of Doyle types II and III mallet finger. MethodsThere were 115 cases of mallet finger deformity with Zone 1 extensor tendon rupture and defect. After debridement by first intention, the tendon bundles of the palmaris longus tendon were used to pass through the subcutaneous tunnel on the volar side of the base of distal phalanx, forming an encircling binding, crossing on the dorsal side. The tail of the tendon was then overlapped with the proximal extensor tendon and sutured. The finger extension position was fixed with plaster for four weeks. If the skin defect could not be closed directly, depending on the size of the skin defect, either a local turndown flap or a pedicled flap was used to cover the wound. ResultsThe patients were followed up for 3–12 months after the operation. According to Total Active Motion criteria, the clinical effect was excellent in 89 cases, good in 16 cases, acceptable in 7 cases, poor in 2 cases and inferior in 1 case. Conclusion: The treatment of Doyle types II and type III mallet finger with the encircling fixation of a transplanted palmaris longus tendon is simple and effective, with a low recurrence rate, few complications, and satisfactory results.

Three-dimensional Printed Customized Adjustable Mallet Finger Splint: A Cheap, Effective, and Comfortable Alternative.

SummaryMallet finger deformity is a common and debilitating injury of the fingertip, accounting for 10% of all tendon and ligament injuries. It involves a disruption of the terminal extensor mechanism of the distal phalanx. Patients can experience significant pain and swelling of the fingertip and have significant morbidity without treatment. Nonoperative treatment using joint immobilization with splints is the mainstay of management. Traditionally, prefabricated and thermoplastic splints have been utilized; however, issues with comfort and skin complications such as maceration can lead to patient noncompliance and eventually, poor outcomes. To address this, we demonstrate our experience with the design, manufacture, and application of individualized 3D printed mallet finger splints. The splints were found to provide advantages akin to traditional thermoplastic splints, with the addition of being low cost, easy to manufacture, and environmentally friendly.

A single K-wire to prevent poor outcomes in closed soft-tissue mallet finger management due to patient non-compliance.

Soft-tissue mallet finger occurs due to loss of terminal extensor tendon secondary to rupture of distal phalanx. Although using noninvasive splints for 6-8weeks is the gold standard for conservative treatment of closed soft-tissue mallet injuries, patient compliance is an important factor impacting on patient outcomes. In this study, we used a single Kirschner Wire (K-W) to fix the distal interphalangeal (DIP) joint in extension in those patients failed to comply with routine splinting. In this prospective study, 190 patients with Doyle type 1 closed soft-tissue mallet finger deformity were included in four groups between 2011 and 2015. These groups were determined according to treatment modalities. Patients in the first group were treated with a finger splint (n = 109). Patients in the second group first received a finger splint and then K-W was applied due to lack of adequate compliance (n = 23). Patients in the third group were treated with K-W only (n = 47), and the fourth group did not accept surgical treatment nor conservative treatment (n = 11). After 20weeks of follow up, we evaluated the results with functional measurements according to Crawford criteria and patient satisfaction. Additionally, the mid-term outcome was assessed with a follow-up at 2years. At 20th week postoperatively, average DIP extension lag was 6 degrees (0-30) for the first group, 6.1 degrees (0-30) for the second group, 3.8 degrees (0-25) for the third group, and 17.3 degrees (7-30) for the fourth group. Total patient satisfaction was 85%, which was considered excellent or good. Swan neck deformity was observed in 11% of patients. Osteomyelitis and KW related complications were not observed. There were no statistically significant differences between short-term and mid-term results. Internal fixation via K-W may be a suitable treatment option compared to splint therapy for management of closed soft-tissue mallet finger in noncompliant patients. Using this treatment approach, the success rate for patients could satisfactorily be improved.

Treatment of tendinous mallet finger deformity with a part of the flexor digitorum profundus tendon.

To introduce and evaluate an updated surgical technique for the treatment of tendinous mallet finger deformity. From April 2017 to September 2018, 13 cases of tendinous mallet finger deformity were treated. All patients had zone I extensor tendon rupture, with no residual tendon at the insertion for suture, and no avulsion fracture in the distal phalanx. Extensor tendon insertion reconstruction was realized by suturing the transferred portion of the flexor digitorum profundus tendon with the proximal end of the extensor tendon via a constructed bone tunnel. The treatment efficacy of the enrolled patients was evaluated by using Dargan evaluation criteria post-operatively. All patients were followed up with an average duration of 10.6 months. At the last follow-up, 12 patients showed excellent function recovery and one case had unsatisfactory outcome according to the Dargan evaluation criteria. Satisfactory therapeutic outcome for the treatment of tendinous mallet finger deformity can be achieved by reconstructing extensor tendon insertion using a part of the flexor digitorum profundus tendon, implying that the proposed treatment method is worthy of clinical application.

Treatment of mallet finger deformity by reconstruction of the terminal extensor tendon insertion with Endobutton CL BTB

Objective Purpose To introduce the treatment of mallet finger deformity by reconstruction of the terminal extensor tendon insertion with endobutton CL bone-tendon-bone (BTB), and discuss its clinical effects. Methods From January 2010 to August 2013, 21patients (male 15, female 6) with mallet finger deformity were retrospectively studied. The average age of patients was 31.3±5.3 years. The time from injury to surgery was 5.2±2.1 d. Extensor tendons were ruptured at the terminal insertion in all patients, and there were no avulsion fracture at the base of the distal phalanx.. the terminal extensor tendon insertion Awere surgical reconstructed with Endobutton CL BTB, via a dorsal S-shaped incision of distal interphalangeal joint. Dorsal base of the distal phalanx was drilled a hole and then the tendon suture line with Endobutton CL BTBwas inserted from the ventral finger to the dorsal base of the phalanx to suture the proximal extensor tendon. The function of the affected finger was evaluated according to the Crawford standard after operation and follow-up: the active flexion and extension range of motion of each joint of the affected finger and the contralateral healthy finger were measured, and the total active ranges of motion of the finger were recorded. Finger function was evaluated according to the total active range of motion (TAM) system of the American Association of hand Surgeons. Results All 21 cases were followed up and the follow-up period was 8 to 24 months, with an average of 18.6±5.1 months. The operation time of the patients was 20-40 min, with an average of 29.6±10.3 min. The intraoperative blood loss was 5-10ml, with an average of 7.5±2.6 ml. Mallet finger deformities were all corrected postoperatively. One case presented with limited dorsal extension with elongation of -20°. According to the Crawford evaluation standard, there were 18 excellent patients and 2 good patients, with the excellent and good rate was 95.2% (20/21). The degrees of active joint activity were: 91°±7° of the metacar-pophalangeal joint, 92°±4° of the proximal interphalangeal joint, 82°±8° of the distal interphalangeal joint, and 259°±15° of total active activity. The TAMs of the healthy side were 259°±15°, and the TAMs of the affected side were 268°±12°, the difference was statistically significant (t=2.147, P=0.038). Accorrding to TAM system assessment criteria: excellent in 18 patients, good in 2 patients, and the excellent and good rate was 95.2% (20/21). One case presented with dorsal extension limitation, one case suffered from discomfort of grip because of scar in ventral side of the finger. The postoperative dorsal extension was limited in 3 cases, and the postoperative dorsal extension function was gradually restored 6 months later. Conclusion The treatment of mallet finger deformity by reconstruction of the terminal extensor tendon insertion with Endobutton CL BTB was effective and easy-operating. Postoperative patients can perform early finger function exercise, satisfactory results, worthy of clinical promotion and application. Key words: Hand deformities, acquired; Tendinopathy; Reconstructive surgical procedures; Treatment outcome

Fowler Central Slip Tenotomy or Spiral Oblique Retinacular Ligament Reconstruction? A Cadaveric Biomechanical Study in Swan-Neck Deformity.

Background: The goal of this study is to biomechanically compare Fowler central slip tenotomy with spiral oblique retinacular ligament (SORL) reconstruction in correcting a chronic mallet deformity as part of a swan-neck deformity. Methods: We used 24 human cadaver fingers from 6 hands. Mallet finger and swan-neck deformities were created; then, Fowler tenotomy was done on one group including 3 hands with 12 fingers, and SORL reconstruction was done on the others. Results: During simulated finger extension, there was no significant difference between the 2 techniques in correcting the distal interphalangeal joint droop; however, Fowler tenotomy resulted in hyperflexion of the proximal interphalangeal (PIP) joint, whereas it remained straight after SORL reconstruction. Conclusions: This study supports the SORL reconstruction in correcting a chronic mallet deformity, especially when there is a concomitant PIP hyperextension deformity, which lowers the risk of reversing the deformity after a Fowler procedure.

Scar overlapping suture for treating chronic tendinous mallet finger in children

PurposeTo evaluate the effect of scar overlapping suture for treating chronic tendinous mallet finger deformity in children.MethodsSix patients younger than 18 years were investigated retrospectively. The active extensor lags of the distal interphalangeal joint (DIPJ) were all more than 40°, and the passive ranges of DIPJ motion were normal. They were all treated surgically by scar overlapping suture technique, featuring careful overlapping suture of the extensor scar and temporary transarticular Kirschner wire fixation of the DIPJ.ResultsAverage follow-up was 3.1 years (ranging from 2 to 5 years). All patients made significant improvement in DIPJ activity. Three patients achieved full active DIPJ extension, whereas one patient had a 10° extensor lag and two patients had 5° extensor lags. All patients achieved normal active flexion ranges and full passive motion ranges of DIPJ compared with their uninjured side. There was no bone dysplasia, pain, or deformity recurrence.ConclusionsScar overlapping suture for treating chronic tendinous mallet finger in children is safe and effective. According to the Crawford criteria, all patients were graded as excellent.

Reconstruction of extensor tendon insertion in situ for treatment of tendinous mallet finger deformities

Objective To explore the clinical efficacy of reconstruction of extensor tendon insertion in situ for treatment of tendinous mallet finger deformities. Methods From August 2015 to July 2017, 10 cases of tendinous mallet finger deformities were treated with the modified method. Specifically, three bone holes were drilled obliquely by 15 gauge needle at the distal phalanx dorsal base of the injured finger. The proximal of extensor tendon was fixed to the distal phalanx dorsal base with 4-0 tendon suture through the bone holes. Four weeks after the operation, external fixation was removed and moderate active flexion and extension exercises were started. After 8 weeks, the rehabilitation training could be gradually strengthened. Results All the cases were follow-up from 3 to 10 months with an average of 7 months. The wounds all achieved primary healing. The mallet finger deformities were corrected. There is no pain in the movement of the injured finger. According to the evaluation system of Crawford mallet finger evaluation system, the results were excellent in 8 cases and good in 2 cases. Conclusion It is a simple and effective surgical method to reconstruct the extensor tendon insertion by using this modified method. Key words: Surgical procedures, operative; Treatment outcome; Tendinous mallet finger; Extensor tendon insertion

Treatment of Mallet Finger Deformity with Ring Splint

Treatment of Mallet Finger Deformity with Ring Splint

Patient satisfaction after hook plate treatment of bony avulsion fracture of the distal phalanges

BackgroundBony avulsion fractures of the distal phalanges can result in mallet finger deformity if not treated appropriately. Therefore, only minimally displaced fractures can be treated conservatively with a good outcome, as dislocation occurs very often. Several surgical treatment options have been developed during the past decades. Data concerning the recently developed hook plate are promising. So far, no data concerning the subjective satisfaction with this method have been published. Therefore, we have analyzed the outcome after hook plate implantation using a self-assessment score, which focuses also on subjective parameters and satisfaction.MethodsStandardized questionnaires (self-assessment scores and SF-36 questionnaire) were sent to each patient treated with a hook plate due to fracture of the distal phalanx, type Doyle IVb and IVc. Clinical data were evaluated according to the medical record. Scores given per question range from 0 to 10, 10 is the worst and 0 the best outcome.ResultsFrom 69 patients treated, 38 (58%) were enrolled. The whole collective (n = 38) reached a score of 39.7 ± 28.7 points, while men had slightly better results. Men (n = 24) achieved 37.3 ± 27.9 points, women (n = 14) 43.9 ± 30.7 points. Women had significantly better results when analyzed later than 12 months after surgery (52.1 ± 27.9 vs. 29.1 ± 32.8), whereas no changes could be detected in the male group (37.1 ± 29.9 vs. 37.4 ± 27.6). Overall, men were slightly more satisfied than women. Most satisfaction was found regarding pain and fine motor skills (0–0.46 points). Esthetic aspect and nail deformities (3.65 points average) led to the highest dissatisfaction. No differences in the SF 36 score could be detected.ConclusionsThe hook plate is not only a convenient method but it also results in high patient satisfaction. Nail deformities are challenging; however, with increasing experience of the surgeon they decrease. SF 36 score is not an appropriate testing tool for this problem.

Short-term effectiveness of Kirschner wire elastic fixation in treatment of Doyle type Ⅰ and Ⅱ mallet finger

To evaluate the short-term effectiveness of Kirschner wire (K-wire) elastic fixation in the treatment of Doyle type Ⅰ and Ⅱ mallet finger. Between July 2016 and March 2017, 18 patients with Doyle type Ⅰ and Ⅱ mallet finger were treated. There were 12 males and 6 males, with an average age of 45 years (range, 16-61 years). The index finger was involved in 2 cases, the middle finger in 3 cases, the ring finger in 10 cases, and the little finger in 3 cases. The interval from injury to operation ranged from 2 hours to 45 days (median, 5.5 hours). There were 8 patients of closed wound and 10 patients of open wound. Fourteen patients were simply extensor tendon rupture and 4 were extensor tendon rupture complicated with avulsion fracture. The distal interphalangeal joints (DIPJ) of injured fingers were elastically fixed with the K-wire at mild dorsal extend position. The K-wire was removed after 6 weeks, and the functional training started. The operation time was 34-53 minutes (mean, 38.9 minutes). Patients were followed up 3-8 months (mean, 5 months). All incisions healed primarily and no K-wire loosening or infection happened during the period of fixation. All mallet fingers were corrected. The range of motion (ROM) in terms of active flexion of injured DIPJ was (75.83±11.15)° at 6 weeks after operation, showing significant difference when compared with the normal DIPJ of contralateral finger [(85.28±6.06)°] ( t=3.158, P=0.003). The ROM in terms of active flexion was (82.67±6.78)° in 15 patients who were followed up at 8 months after operation, showing no significant difference when compared with the normal DIPJ of contralateral finger [(86.00±5.73)°] ( t=1.454, P=0.157). After the removal of K-wire at 6 weeks, visual analogue scale (VAS) score of active flexion and of passive flexion to maximum angle were 1.78±0.88 and 3.06±1.06, respectively. According to the total active motion criteria, the effectiveness was rated as excellent in 10 cases, good in 5 cases, moderate in 2 cases, and poor in 1 case, and the excellent and good rate was 83.33%. The patients' satisfaction were accessed by Likert scale, which were 3-5 (mean, 4.2). K-wire elastic fixation in the treatment of Doyle typeⅠand Ⅱ mallet finger can repair the extensor effectively, correct the mallet finger deformity, and also be benefit for the flexion-extension function restoration of DIPJ.

Conservative management equally effective to new suture anchor technique for acute mallet finger deformity: A prospective randomized clinical trial

Study DesignProspective randomized controlled trial. Purpose of the StudyThis study was designed to compare our new suture anchor technique with conservative management in acute Wehbe-Schneider type I A-B and II A-B mallet fingers. MethodsTwenty nine patients who presented to our clinic between 2013 and 2015 were randomized for surgical or conservative treatment. Wehbe-Schneider subtype C fractures were excluded. Fourteen were treated with surgery, and 15 were treated with conservative treatment. Primary outcomes were visual analog scale score, active distal interphalangeal (DIP) joint flexion, return to work, extension deficit and DIP joint degeneration. Follow-up time was 12 months. ResultsThe mean visual analog scale was 2.0, and return to work was on average in 63.2 days in the surgical group and 1.47 and 53.7 days in the conservative group. Extension deficit was 8.1° in the surgical group and 6.1° in the conservative group. The mean DIP flexion at final follow-up was 54.5° (40-65) in the surgery group and 58.3° (45-70) in the conservative group. DIP joint degeneration was observed with X-rays in 4 patients in surgical group, and none of the patients in the conservative group had DIP degeneration at 1 year after treatment. ConclusionsThe therapeutic effectiveness of suture anchor technique was not statistically different from conservative treatment. Subluxation seen after fixation treatment with suture anchors may be due to inadequate anchor fixation. DIP joint degeneration was seen significantly more in the surgical group. Our study suggests that the new suture anchor technique is not superior to conservative treatment. Level of EvidenceIb.

Simultaneous Bony Mallet Fingers of Two Phalanx in a Patient: A Rarely Seen Case Report

Mallet finger deformity is a common hand injury and usually occurs after a direct impact of sudden and extreme trauma forcing the distal interphalangeal Mallet finger deformity is a common hand injury and usually occurs after a direct impact of sudden and extreme trauma forcing the distal interphalangeal joint to get flexion with an extended proximal interphalangeal joint. Deformity is especially associated with ball use disrupting the extensor mechanism at the base of distal phalanx. Mallet finger deformity in acute stage can be treated by immobilization of distal interphalangeal joint with hyperextension splints. But the surgery becomes the choice in delayed cases and if there is a fracture including more than one third of articular surface of distal interphalangeal joint or distal phalanx volar subluxation. In the literature there are great sum of studies including mallet finger deformities as simultaneous, bilateral or multiple variations and treatment strategies. But in the literautre there is no study about simultaneous bony mallet fingers deformity reported. Here, we present the case of a 30 year old female with simultaneous bony mallet fingers in the third and fourth ray and the conservative treatment of with splinting for six weeks. At the last time follow up the patient was able to use her hand without any diffuculty and she had full range of motion of distal interphalangel joint.

A New Treatment Modality for Mallet Finger Deformity: 4-2-2 Protocol

A New Treatment Modality for Mallet Finger Deformity: 4-2-2 Protocol