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Surgical and Nonsurgical Management of Mallet Finger: A Systematic Review
Journal article   Peer reviewed

Surgical and Nonsurgical Management of Mallet Finger: A Systematic Review

James S Lin and Julie Balch Samora
The Journal of hand surgery (American ed.), Vol.43(2), pp.146-163.e2
02/2018
DOI: 10.1016/j.jhsa.2017.10.004
PMID: 29174096
url
https://doi.org/10.1016/j.jhsa.2017.10.004View
Published (Version of record) Open Access

Abstract

The current literature describes multiple surgical and nonsurgical techniques for the management of mallet finger injuries, and there is no consensus on the indications for surgical treatment. The objective of this study was to determine, through a literature review, if any conclusions can be drawn concerning the indications for surgery in mallet finger injuries; the treatment outcomes of surgical versus nonsurgical management; the most effective methods of surgical and nonsurgical treatment; and the most common treatment complications of mallet finger injuries. A systematic review of multiple databases was performed. English language clinical studies evaluating therapeutic interventions for mallet fingers that reported objective, standardized outcome measures were included. Basic science studies, cadaveric studies, conference abstracts, level V evidence studies, studies lacking statistical data, and tendinous injuries other than mallet fingers were excluded. Salvage procedures and studies evaluating exclusively chronic lesions were also excluded. Forty-four studies that reported clinical outcomes for the treatment of mallet finger injuries, 22 evaluating surgical treatments and 17 studies investigating nonsurgical treatments were included. The average distal interphalangeal joint extensor lag was 5.7° after surgical treatment and 7.6° after nonsurgical treatment. Complication rates of surgical and nonsurgical interventions were comparable (14.5% and 12.8%, respectively). Five studies directly compared the outcomes of surgical with nonsurgical management, with mixed results and recommendations. Both surgical and nonsurgical treatments of mallet finger injuries lead to excellent clinical outcomes. Insufficient evidence is available to determine when surgical intervention is indicated. Based on our literature review, it appears that these treatments are equivalent and should be individualized to the patient. Therapeutic IV.
Bandages Finger Injuries - therapy Fracture Fixation Fractures, Bone - therapy Humans Splints Tendon Injuries - classification Tendon Injuries - therapy Treatment Outcome

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