Mallet Finger Fracture
Conditions
Keywords
Conservative treatment, crawford criteria, extension-block pinning technique, mallet fracture, pin orthosis
Brief summary
Mallet finger fractures are injuries affecting the tip of the finger and can be treated either with splinting or surgery. However, there is no clear agreement on which treatment provides better outcomes for certain types of these fractures. In this study, patients with mallet finger fractures were randomly assigned to receive either surgical treatment using a pin-orthosis extension-block pinning technique or conservative treatment with splint immobilization. Patients were followed at regular intervals, and outcomes such as finger movement, function, bone healing, and complications were evaluated over time. The purpose of this study is to compare these two treatment approaches and determine which one leads to better clinical and functional outcomes.
Detailed description
Mallet finger fractures, particularly those involving a significant portion of the distal interphalangeal joint articular surface, present a therapeutic challenge, and there is no consensus regarding the optimal treatment strategy. Both conservative management with splinting and various surgical techniques have been described in the literature. This randomized controlled trial was designed to compare the clinical and radiographic outcomes of the pin-orthosis extension-block pinning technique and conventional conservative treatment in patients with mallet finger fractures. Patients were randomly assigned to either surgical or conservative treatment groups and followed at regular intervals. Clinical and functional outcomes were assessed throughout the follow-up period to evaluate the effectiveness and safety of both treatment approaches."
Interventions
PROCEDUREPin-Orthosis Extension-Block Pinning Technique
The pin-orthosis extension-block pinning technique was performed under appropriate anesthesia. A Kirschner wire was used to block extension at the distal interphalangeal joint and stabilize the fracture fragment, followed by immobilization with an orthosis. The fixation was maintained for a defined period, and patients were followed according to the study protocol.
PROCEDURESplinting
Conservative treatment consisted of continuous splint immobilization of the distal interphalangeal joint in extension. Patients were instructed to maintain uninterrupted splint use for the recommended duration with regular follow-up visits to monitor compliance and clinical progress.
Sponsors
Haseki Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants were randomly assigned to one of two parallel groups: surgical treatment using the pin-orthosis extension-block pinning technique or conservative treatment with splinting. Each participant remained in the assigned group throughout the study
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age between 18 and 65 years * Acute mallet fracture (≤ 3 weeks from injury) * Fracture fragment involving 20-50% of the distal interphalangeal (DIP) joint articular surface
Exclusion criteria
* Open fractures * Chronic mallet fractures (\> 3 weeks from injury) * Fracture fragment involving more than 50% of the DIP joint articular surface * Open physes * Inability to complete 12-month follow-up
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Distal Interphalangeal Joint Extension Lag | 12 months | Degree of extension lag at the distal interphalangeal joint measured using a goniometer. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Distal Interphalangeal Joint Range of Motion | Up to 12 months (assessed at 2 weeks, 4 weeks, 6 weeks, 3 months, 6 months, and 12 months) | Range of motion of the distal interphalangeal joint measured in degrees. |
| Functional Outcome According to Crawford Criteria | 12 months | Functional outcome assessed using the Crawford classification system. |
| Fracture Union | Up to 12 months (assessed at 6 weeks, 3 months, 6 months, and 12 months) | Radiographic evidence of fracture healing assessed during follow-up. |
| Complication Rate | Up to 12 months | Incidence of treatment-related complications observed during the study period. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORKemal A Col, Doctor
Haseki Training and Research Hospital
Outcome results
None listed