Objective:
Splints that immobilize distal interphalangeal joint (DIP) in extension are used successfully for the treatment of mallet finger deformity. In case of unsuccessful splinting, surgical techniques can be used. In this study, it was aimed to present an alternative surgical technique in combination with splinting and rehabilitation program allowing early active controlled movement.
Material and Methods:
In the study, postoperative 1 year results of 27 patients with an unsuccessful splinting program were evaluated retrospectively. As surgical technique, open reduction and fixation of DIP with kirschner wire was performed. Prolene suture was passed through eponychium of ulnar and radial sides of the nail and extensor tendon. Then, suture was secured on kirschner wire. At postoperative 4th week, wire was removed and suture holding the tendon was tied on a metal hook adhered to nail plate. Standard Stack splint was used for 2 weeks for immobilization. During this period, additionally, a progressive exercise program was given with a thermoplastic splint at 15 and 25 degrees of flexion. At postoperative 6th week, night splinting was begun for additional two weeks.
Results:
Average extension lag of DIP joint was 1.70 at postoperative 1 year. Full extension was present in 19 patients and average extension lag of 5.80 was present in 8 patients (2-100). According to the Crawford’s evaluation criteria, 19 patients were accepted as perfect and remaining 8 patients were accepted as good.
Conclusion:
In conclusion, surgical technique with 4-2-2 protocol seems to be an effective alternative to previously defined surgical procedures with low complication rates and good functional outcome.
Keywords: finger, hand deformity, hand, mallet finger