Overview
Mallet finger, also known as baseball finger, involves injury to the extensor tendon at the distal interphalangeal (DIP) joint of the finger, often resulting in flexion deformity 13.Diagnosis
Clinical Presentation: Pain, swelling, and inability to extend the distal phalanx 3.
Imaging: X-rays to rule out bony injury; MRI may be used for soft tissue assessment 3.
Grading: Often based on the degree of DIP joint extension lag angle 1.Management
First-Line Treatment: Conservative management with a splint (typically dorsal splint) to maintain DIP joint extension 13.
Splinting Techniques: Modified dorsal splints recommended for proper immobilization and comfort 3. Special splinting methods for occupational needs (e.g., surgeons) may be considered 2.
Surgical Intervention: Considered in cases of nonunion, severe deformity, or failed conservative treatment; no strong evidence favoring surgery over splinting 1.Special Populations
Surgeons: Custom splinting methods allowing continued hand hygiene and surgical activity may be beneficial 2.Key Recommendations
Conservative treatment with a dorsal splinting is recommended for most mallet finger cases to achieve similar clinical outcomes as surgical intervention 1 (Evidence: Moderate).
Custom splinting techniques can be employed to accommodate specific occupational needs, such as maintaining surgical practice 2 (Evidence: Weak).
Surgical intervention should be reserved for cases with nonunion, severe deformity, or failure of conservative management 1 (Evidence: Moderate).References
1 Peng C, Huang RW, Chen SH, Hsu CC, Lin CH, Lin YT et al.. Comparative outcomes between surgical treatment and orthosis splint for mallet finger: a systematic review and meta-analysis. Journal of plastic surgery and hand surgery 2023. link
2 Cascio BM, Chang TL, Pateder DB, Ain MC. Tip of the trade: a method of splinting for surgeons. Journal of surgical orthopaedic advances 2006. link
3 Hart RG, Kleinert HE, Lyons K. The Kleinert modified dorsal finger splint for mallet finger fracture. The American journal of emergency medicine 2005. link