Mallet finger: Difference between revisions
| Line 25: | Line 25: | ||
==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 | *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 | ||
Revision as of 17:19, 5 July 2017
Background
- Rupture of extensor tendon in area of distal phalanx distal to DIP joint
- May be accompanied by avulsion fracture
- Caused by forced flexion of the DIP joint
Clinical Features
- Results in DIP joint flexed 40'
- Untreated leads to swan neck deformity
- Flexed DIP
- Hyperextended PIP
Differential Diagnosis
Hand and finger injuries
- Distal finger
- Other finger/thumb
- Boutonniere deformity
- Mallet finger
- Jammed finger
- Jersey finger
- Trigger finger
- Ring avulsion injury
- De Quervain tenosynovitis
- Infiltrative tenosynovitis
- Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb)
- Hand
- Wrist
- Drummer's wrist
- Ganglion cyst
- Lunotriquetral ligament instability
- Scaphoid fracture
- Extensor digitorum tenosynovitis
- Compressive neuropathy ("bracelet syndrome")
- Intersection syndrome
- Snapping Extensor Carpi Ulnaris
- Vaughn Jackson syndrome
- General
Evaluation
Workup
- 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
- Splint DIP joint in continuous slight hyperextension x 6 wk
- Splinting of the PIP joint is not necessary[1]
- Inadvertently splinting PIP for 6 weeks results in collateral ligamentous overgrowth and functional disability
- Give an extra splint
Disposition
- Hand surgery follow-up in 7-10 days
See Also
References
- ↑ Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84