Splinting Best Treatment for Mallet Finger

There are several treatment options for mallet finger.Splinting is the most common initial treatment method for soft tissue or bony mallet finger. Regardless of the treatment option, common sequelae include a slight extensor lag and a prominent bump on the dorsum of the finger.Many splint configurations and surgical techniques have been described over the past several decades. However, the optimal treatment of each type of mallet finger injury remains controversial. 

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An excellent outcome is no pain with full range of motion at the DIP joint, less than 10-degree extension deficit is a good outcome, 10–25 degrees of extension deficit with no pain is a fair outcome, and more than 25 degrees of extension deficit or persistent pain is considered a poor outcome. A Mallet Finger treatment outcome assessment classification was proposed by Crawford. It is the most commonly used classification for outcome assessment after mallet finger.

Makhlouf and Deek have considered surgery when splinting cannot correct acute deformities; however, we will review the present literature for acute open and chronic deformities. Most surgeons believe closed/non-operative treatment using splints produces satisfactory results for tendon avulsions without fracture and minimally displaced or small fractures.

Mallet Finger

The authors feel non-operative management of mallet finger is indicated in cases of all soft tissue mallets and bony mallets which are well reduced in a splint without DIP joint subluxation. Immobilization of both the PIP and DIP joints was previously thought to be necessary to relax the extensor hood and intrinsic musculature during terminal extensor tendon healing. 

Whether PIP joint motion would cause a tendon gap at the immobilized DIP joint. They demonstrated that gapping of a disrupted terminal extensor tendon occurred as a result of excursion of the distal tendon stump during DIP joint flexion, not because of retraction of the proximal portion of the tendon with simulated PIP joint extension. They concluded that only the DIP joint need be immobilized in extension to allow healing of the mallet injury. Most authors currently advocate immobilization of the DIP joint alone 

Splinting

There are many variations in the design of splints, but the principle is the same. All Frog Splint Mallet Finger are designed to maintain full extension or slight hyper extension at the DIP joint. Commonly used splints are plastic stack splints, thermoplastic, and aluminum form splints. The authors recommend full time splinting for 6 weeks, followed by 2–6 weeks of splinting at night. The splint should be used continuously and the DIP joint should be maintained in full extension even during skin hygiene care.

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Patients should be instructed on how to change the splint for periodic cleaning and examination of the skin without allowing the DIP joint to flex. Neglecting a mallet injury or incorrect treatment can lead to DIP joint dysfunction. 1 mm lengthening of the terminal extensor tendon results in 25 degrees of extension lag, and a shortening of 1 mm will seriously restrict DIP joint flexion.

There are several studies comparing mallet finger splints. Perforated splints are better tolerated than solid stack splints. Aluminum-alloy malleable splints are associated with more skin complications as compared with the stack splint, but final outcomes are similar. Warren compared the use of the Abouna splint (rubber coated wire splint) versus the stack splint in a randomized study involving 116 patients.

The Abouna splint had skin complications and poorer patient satisfaction but similar final outcomes as compared with the stack splint. Pike et al. compared the clinical and radiographic extensor lag measurements for mallet fingers treated with volar, dorsal, and custom thermoplastic splinting. There was no extensor lag difference between splints at 12-week follow-up and increased extensor lag was noted with all three splints after discontinuation at 6 weeks of time.

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Splint Like A Device for Immobilizing Injured Parts of Body

A splint is a piece of medical equipment used to keep an injured body part from moving and to protect it from any further damage.

A splint is applied to a fracture, sprain, or areas with extensive injury to soft tissues; A device for immobilizing injured parts of the body. Finger Mallet Splint is also applied in cases of inflammatory diseases of the limbs, in cases of burns, and after surgery on bones, blood vessels, and nerves in the extremities. A distinction is made between transport and therapeutic splints.

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Bone and joint injuries of the hand are common. While often viewed as trivial injuries, a poorly treated finger fracture can have significant functional consequences. These injuries may result in chronic pain, stiffness, and deformity; preventing patients from participating in activities of daily living. It is not uncommon for stable fractures to be over treated and unstable fractures to be neglected, both potentially resulting in permanent disability. Accurate diagnosis and timely management of these injuries continues to be the cornerstone of optimal hand care.

Finger fractures are common injuries with a wide spectrum of presentation. Although a vast majority of these injuries may be treated non-operatively with gentle reduction, appropriate splinting, and careful follow-up, health care providers must recognize injury patterns that require more specialized care.

Injuries involving unstable fracture patterns, intra-articular extension, or tendon function tend to have suboptimal outcomes with non-operative treatment. Other injuries including terminal extensor tendon injuries (mallet finger), stable non-articular fractures, and distal phalanx tuft fractures are readily treated by conservative means, and in general do quite well. Appropriate understanding of finger fracture patterns, treatment modalities, and injuries requiring referral is critical for optimal patient outcomes.

Mallet Fractures

The majority of distal phalangeal base fractures are “mallet injuries”, occurring due to an axial load with a resultant disruption of the terminal extensor mechanism. Mallet injuries with and without a bony fragment may be effectively treated by splinting the DIP joint in extension for 8 wks, followed by 1 month of night splinting. Splinting using a dorsal, volar, or pre-fabricated Stack type splint are all reasonable treatment methods. Care must be taken to avoid dorsal skin ischemia and potential breakdown seen in cases of splinting the DIP joint in a hyperextended position.

Frog Finger Malleable segments fold to hold finger in desired alingment for immobilization of the distal part of injured. Frog Splint is mainly used for fastening of the 1st and 2nd joints of fingers. It is convenient to use and simple for operation.

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Mallet Finger Splint Supports the Dip Joint in Hyper Extension

A splint is a device that supports and protects body parts that have been injured, such as a broken bone or muscle sprain. A splint may also be worn after surgery. A splint is used to decrease pain and stop or limit movement so you can heal. Unlike casts, caregivers can easily adjust a splint if you have swelling or pain after an injury. A splint is sometimes called a half-cast because it does not wrap around an entire body area like a cast does. 

A Mallet splint is designed in such a way that it supports the dip joint in hyper extension, while the movement of the PIP joint does not get restricted. Finger Splint is required when the tendon in outermost joint of a finger is ripped. We can also say when the tip of the finger gets injured due to sports injury, or jammed your finger in the door. 

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Mallet Finger Splint Features:

Coated aluminum body

• Malleable can be bent and customized.
• Strong, provides rigid immobilization.
• Light weight.

Ergonomic design

• Highly practical design to maintain the requisite hyper extension of DIP joint.
• Well ventilated and comfortable.
• Sleek and simple –Better compliance.
• Easy application and removal.

Ethafoam lining

• High cushioning.
• Enhanced comfort.
• Easy to clean and maintain.

Inbuilt Hook loop fasteners

• Close fitting and excellent grip
• Easy application and removal.  

Frog Splint is specifically designed to support a sprained finger and immobilizes it. It aligns the inter phalangeal joints by maintaining them in functional position. Frog Splint is quite resilient and can be shaped easily in the desired position for extra firm support. Its arms can be moulded conveniently to grip the finger tightly.It is very difficult and irritating to keep your finger straight and unaffected by any physical contact when the injury is on a single finger.

Frog Splint Features:

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Coated aluminum body

• Extra malleable arms, can be shaped for good grip.
• Strong, provides rigid immobilization.
• Aesthetically pleasing.
• Light weight.

Anatomic design

• Immobilizes both interphalangeal joints in neutral functional position.
• Ensures easy wearing during injury.
• Well ventilated and comfortable.
• Does not restrict the movement of other fingers.
• Sleek, simple and light in weight.

Ethafoam lining

• High cushioning.
• Enhanced comfort.
• Easy to clean and maintain.
• Hypoallergenic, odorless. 

The splint that we make at Medical ensures that the patient suffers no discomfort of any kind while wearing it. It is coated with an aluminum body which can be bent and is customized. It is designed in the most practical way to immobilize only the hyper extension of DIP joint. The inbuilt hook loop fasteners help to easily wear and remove it while giving it an excellent grip. 

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