Mallet finger - Revision history

Rossdonaldson1: /* Background */

2023-03-15T18:05:15Z

Background

← Older revision		Revision as of 18:05, 15 March 2023
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	==Background==		==Background==
	[[File:PMC4807168 aps-43-134-g001.png\|thumb\|Possible mechanisms of injury from axial force applied to the tip of a straight digit (black arrows) causing: (top) DIP joint hyperextension (white upper arrow) and fracture, or (bottom) DIP hyperflexion (lower white arrow) and tendon lesion.]]		[[File:PMC4807168 aps-43-134-g001.png\|thumb\|Possible mechanisms of injury from axial force applied to the tip of a straight digit (black arrows) causing: (top) DIP joint hyperextension (white upper arrow) and fracture, or (bottom) DIP hyperflexion (lower white arrow) and tendon lesion.]]
			[[File:PMC4807168 aps-43-134-g004.png\|thumb\|Mallet finger injury types (Tubiana classification system).]]
	*May be accompanied by avulsion fracture		*May be accompanied by avulsion fracture
	*Caused by forced flexion of extended DIP joint		*Caused by forced flexion of extended DIP joint

Rossdonaldson1 at 02:59, 8 May 2021

2021-05-08T02:59:35Z

← Older revision		Revision as of 02:59, 8 May 2021
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	==Clinical Features==		==Clinical Features==
	[[File:Mallet finger.jpg\|thumb\|Finger in maximum extension]]		[[File:Mallet finger.jpg\|thumb\|Finger in maximum extension]]
	~~[[File:Mallet finger.png\|thumb\|Mallet finger without fracture]]~~
	~~[[File:MalletFinger.png\|thumb\|Mallet finger with fracture at the insertion of the extensor tendon]]~~
	*Rupture of extensor tendon in area of distal phalanx distal to DIP joint		*Rupture of extensor tendon in area of distal phalanx distal to DIP joint
	*DIP joint flexed to 40°, unable to fully extend		*DIP joint flexed to 40°, unable to fully extend
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	==Evaluation==		==Evaluation==
			[[File:Mallet finger.png\|thumb\|Mallet finger without fracture]]
			[[File:MalletFinger.png\|thumb\|Mallet finger with fracture at the insertion of the extensor tendon]]
	*Clinical diagnosis		*Clinical diagnosis
	*Consider finger x-ray (PA and lateral) to evaluate for avulsion fracture		*Consider finger x-ray (PA and lateral) to evaluate for avulsion fracture

Rossdonaldson1 at 02:55, 8 May 2021

2021-05-08T02:55:19Z

← Older revision		Revision as of 02:55, 8 May 2021
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	==Background==		==Background==
	[[File:PMC4807168 aps-43-134-g001.png\|thumb\|Possible mechanisms of injury from axial force applied to the tip of a straight digit (black arrows) causing: (top) DIP joint hyperextension (white upper arrow) and fracture, or (bottom) DIP hyperflexion (lower white arrow) and tendon lesion.]]		[[File:PMC4807168 aps-43-134-g001.png\|thumb\|Possible mechanisms of injury from axial force applied to the tip of a straight digit (black arrows) causing: (top) DIP joint hyperextension (white upper arrow) and fracture, or (bottom) DIP hyperflexion (lower white arrow) and tendon lesion.]]
			*May be accompanied by avulsion fracture
			*Caused by forced flexion of extended DIP joint
			*If untreated, leads to [[swan neck deformity]]

			==Clinical Features==
	[[File:Mallet finger.jpg\|thumb\|Finger in maximum extension]]		[[File:Mallet finger.jpg\|thumb\|Finger in maximum extension]]
	[[File:Mallet finger.png\|thumb\|Mallet finger without fracture]]		[[File:Mallet finger.png\|thumb\|Mallet finger without fracture]]
	[[File:MalletFinger.png\|thumb\|Mallet finger with fracture at the insertion of the extensor tendon]]		[[File:MalletFinger.png\|thumb\|Mallet finger with fracture at the insertion of the extensor tendon]]
	*Rupture of extensor tendon in area of distal phalanx distal to DIP joint		*Rupture of extensor tendon in area of distal phalanx distal to DIP joint
	**May be accompanied by avulsion fracture
	*Caused by forced flexion of extended DIP joint
	*If untreated, leads to [[swan neck deformity]]

	~~==Clinical Features==~~
	*DIP joint flexed to 40°, unable to fully extend		*DIP joint flexed to 40°, unable to fully extend

Rossdonaldson1: /* Background */

2021-05-08T02:54:46Z

Background

← Older revision		Revision as of 02:54, 8 May 2021
Line 1:		Line 1:
	==Background==		==Background==
			[[File:PMC4807168 aps-43-134-g001.png\|thumb\|Possible mechanisms of injury from axial force applied to the tip of a straight digit (black arrows) causing: (top) DIP joint hyperextension (white upper arrow) and fracture, or (bottom) DIP hyperflexion (lower white arrow) and tendon lesion.]]
			[[File:Mallet finger.jpg\|thumb\|Finger in maximum extension]]
			[[File:Mallet finger.png\|thumb\|Mallet finger without fracture]]
			[[File:MalletFinger.png\|thumb\|Mallet finger with fracture at the insertion of the extensor tendon]]
	*Rupture of extensor tendon in area of distal phalanx distal to DIP joint		*Rupture of extensor tendon in area of distal phalanx distal to DIP joint
	**May be accompanied by avulsion fracture		**May be accompanied by avulsion fracture
	*Caused by forced flexion of extended DIP joint		*Caused by forced flexion of extended DIP joint
	*If untreated, leads to [[swan neck deformity]]		*If untreated, leads to [[swan neck deformity]]

	~~[[File:Mallet finger.jpg\|thumb\|Finger in maximum extension]]~~
	~~[[File:Mallet finger.png\|thumb\|Mallet finger without fracture]]~~
	~~[[File:MalletFinger.png\|thumb\|Mallet finger with fracture at the insertion of the extensor tendon]]~~

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* References */

2019-05-10T01:32:38Z

References

← Older revision		Revision as of 01:32, 10 May 2019
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	[[Category:Orthopedics]]		[[Category:Orthopedics]]
			[[Category:Sports Medicine]]

Mholtz at 03:59, 6 July 2017

2017-07-06T03:59:11Z

← Older revision		Revision as of 03:59, 6 July 2017
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	*Rupture of extensor tendon in area of distal phalanx distal to DIP joint		*Rupture of extensor tendon in area of distal phalanx distal to DIP joint
	**May be accompanied by avulsion fracture		**May be accompanied by avulsion fracture
	*Caused by forced flexion of ~~the~~ DIP joint		*Caused by forced flexion of extended DIP joint
			*If untreated, leads to [[swan neck deformity]]

			[[File:Mallet finger.jpg\|thumb\|Finger in maximum extension]]
			[[File:Mallet finger.png\|thumb\|Mallet finger without fracture]]
			[[File:MalletFinger.png\|thumb\|Mallet finger with fracture at the insertion of the extensor tendon]]

	==Clinical Features==		==Clinical Features==
	~~[[File:Mallet finger.jpg\|thumb\|Finger in maximum extension]]~~		*DIP joint flexed to 40°, unable to fully extend
	*~~Results in~~ DIP joint flexed ~~40'~~
	*Untreated leads to ~~swan neck deformity~~
	**Flexed DIP
	**Hyperextended PIP

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	~~===Workup===~~		*Clinical diagnosis
	~~[[File:Mallet finger.png\|thumb\|Mallet finger without fracture]]~~		*Consider finger x-ray (PA and lateral) to evaluate for avulsion fracture
	~~[[File:MalletFinger.png\|thumb\|Mallet~~ finger ~~with fracture at the insertion of the extensor tendon]]~~
	*Finger x-ray (PA and lateral)

	~~===Diagnosis===~~
	~~The injured digit will be often held in flexion with an inability~~ to ~~extend. The diagnosis is clinical although an~~ avulsion fracture ~~should also be ruled out.~~

	==Management==		==Management==
	~~[[File:Splint1.jpg\|thumb\|Special Mallet finger splint (if available)]]~~
	*Splint DIP joint in continuous slight hyperextension x 6 wk		*Splint DIP joint in continuous slight hyperextension x 6 wk
	*Splinting of the PIP joint is not necessary<ref>Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84</ref>		*Splinting of the PIP joint is not necessary and should be avoided<ref>Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84</ref>
	**Inadvertently splinting PIP for 6 weeks results in collateral ligamentous overgrowth and functional disability<ref>Prosser R. Splinting in the management of proximal interphalangeal joint flexion contracture. J Hand Ther. 1996 Oct-Dec;9(4):378-86.</ref>		**Inadvertently splinting PIP for 6 weeks results in collateral ligamentous overgrowth and functional disability<ref>Prosser R. Splinting in the management of proximal interphalangeal joint flexion contracture. J Hand Ther. 1996 Oct-Dec;9(4):378-86.</ref>
	*Give an extra splint		*Give an extra splint

			[[File:Splint1.jpg\|thumb\|Special Mallet finger splint (if available)]]

	==Disposition==		==Disposition==
	*~~Hand~~ surgery follow-up in 7-10 days		*Discharge with hand surgery follow-up in 7-10 days

	==See Also==		==See Also==
	*[[~~Radiograph-Negative~~ Hand and ~~Finger Injuries~~]]		*[[Hand and finger diagnoses]]

	==References==		==References==

Kxl328: /* Management */

2017-07-05T17:20:21Z

Management

← Older revision		Revision as of 17:20, 5 July 2017
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	*Splint DIP joint in continuous slight hyperextension x 6 wk		*Splint DIP joint in continuous slight hyperextension x 6 wk
	*Splinting of the PIP joint is not necessary<ref>Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84</ref>		*Splinting of the PIP joint is not necessary<ref>Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84</ref>
	**Inadvertently splinting PIP for 6 weeks results in collateral ligamentous overgrowth and functional disability		**Inadvertently splinting PIP for 6 weeks results in collateral ligamentous overgrowth and functional disability<ref>Prosser R. Splinting in the management of proximal interphalangeal joint flexion contracture. J Hand Ther. 1996 Oct-Dec;9(4):378-86.</ref>
	*Give an extra splint		*Give an extra splint

Kxl328: /* Management */

2017-07-05T17:19:16Z

Management

← Older revision		Revision as of 17:19, 5 July 2017
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	==Management==		==Management==
	[[File:Splint1.jpg\|thumb\|Special Mallet finger splint (if available)]]		[[File:Splint1.jpg\|thumb\|Special Mallet finger splint (if available)]]
	*Splint DIP joint in continuous slight hyperextension x ~~6wk~~		*Splint DIP joint in continuous slight hyperextension x 6 wk
	*Splinting of the PIP joint is not necessary<ref>Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84</ref>		*Splinting of the PIP joint is not necessary<ref>Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84</ref>
			**Inadvertently splinting PIP for 6 weeks results in collateral ligamentous overgrowth and functional disability
	*Give an extra splint		*Give an extra splint

Rossdonaldson1: /* Management */

2017-04-28T21:15:05Z

Management

← Older revision		Revision as of 21:15, 28 April 2017
Line 28:		Line 28:
	*Splinting of the PIP joint is not necessary<ref>Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84</ref>		*Splinting of the PIP joint is not necessary<ref>Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84</ref>
	*Give an extra splint		*Give an extra splint

			==Disposition==
	*Hand surgery follow-up in 7-10 days		*Hand surgery follow-up in 7-10 days

Rossdonaldson1: /* Management */

2017-04-28T21:14:44Z

Management

← Older revision		Revision as of 21:14, 28 April 2017
Line 24:		Line 24:

	==Management==		==Management==
			[[File:Splint1.jpg\|thumb\|Special Mallet finger splint (if available)]]
	*Splint DIP joint in continuous slight hyperextension x 6wk		*Splint DIP joint in continuous slight hyperextension x 6wk
	*Splinting of the PIP joint is not necessary<ref>Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84</ref>		*Splinting of the PIP joint is not necessary<ref>Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84</ref>