A Model for the Conservative Management of Mallet Finger

Richards, Steve; Kumar, Gunasekaran; Booth, Susanne; Naqui, S. Z.; Murali, S. R.

doi:10.1016/s0266-7681(03)00220-1

Cited by 37 publications

(22 citation statements)

References 7 publications

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“…This development should be in line with the priorities of HSE who state that 'the focus will be on standardizing care and implementing proven solutions to save lives, prevent complications, remove waiting lists and save money' ( p. 3). 1 Many authors to date 13,14,[16][17][18] have provided evidence of service delivery initiatives, which have indeed achieved these improvements sought by the HSE, and provide a template that is transferrable to the Irish health-care system. The widespread establishment of a model of service delivery, which facilitates direct referral from the emergency department to the occupational therapist would reduce delays and disruption in treatment access and provide the patient with the appropriate care at the appropriate time.…”

Section: Resultsmentioning

confidence: 99%

“…The literature indicates that mallet injury can be managed in the emergency department, 9 general practice, 10,11 consultant-led clinics 12 and therapy-led clinics. [13][14][15] In an Irish context, emergency departments are most likely to provide the first point of contact for many of these patients. While appropriate diagnosis and treatment in the emergency department is critical to the ultimate outcome, 'closed tendon injuries of the hand are unfortunately often not treated with the same respect as other hand injuries' (p. 76), 9 thereby adding to the risk of long-term disability or deformity.…”

Section: Mallet Finger and Managementmentioning

confidence: 99%

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Investigation of the conservative management of mallet injury in Irish acute hospitals

Minchin

Spirtos

2012

Hand Therapy

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Introduction. Mallet injury is a commonly treated hand injury in acute hospitals. While there is much literature regarding the various treatment options and outcomes, no studies were found that describe the management of this injury across a national health service. This study describes how mallet injury is managed within the acute hospital system in Ireland. An understanding of the current system of service provision is essential for future service development in this area. Method. Emergency and occupational therapy departments in the 29 acute case-mix hospitals in Ireland were contacted by telephone and postal questionnaire with 47 respondents participating in the study. Descriptive statistics are used to present the results. Results. Results indicate that accessing acute hospital-based services for the conservative management of mallet injury typically follows a predictable pathway, but can result in delays and disruption to treatment for the patient. There is little evidence of direct referral from the emergency department to the occupational therapist which, when compared with published literature, would represent the most efficient and optimum care pathway for the patient. The choice of splint used by both the emergency and occupational therapy departments differs, but treatment provided is in line with available evidence-based practice.Conclusions. This preliminary study provides a basis for future service development in the acute management of mallet injury, by describing how treatment is currently provided nationally. Recommendations for further investigation have been made, and the need for audit and outcome measurement has been highlighted. The development of therapy-led services in Ireland is proposed, to improve efficiency and quality of service provision in the conservative management of mallet injury.

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Section: Resultsmentioning

confidence: 99%

Section: Mallet Finger and Managementmentioning

confidence: 99%

Investigation of the conservative management of mallet injury in Irish acute hospitals

Minchin

Spirtos

2012

Hand Therapy

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“…Richards and colleagues published a series of 34 patients treated with a custom thermoplastic splint and reported 30 of 34 successful outcomes based on Abouna and Brown's criteria. 2 Few comparative studies are available regarding splinting techniques for mallet deformity. Warren et al compared the Abouna splint with the Stack splint across 116 patients and found no difference in final improvement in extensor lag.…”

Section: Discussionmentioning

confidence: 99%

Blinded, Prospective, Randomized Clinical Trial Comparing Volar, Dorsal, and Custom Thermoplastic Splinting in Treatment of Acute Mallet Finger

Pike¹,

Mulpuri²,

Metzger³

et al. 2010

The Journal of Hand Surgery

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“…For non-complicated cases some authors recommend conservative treatment, usually by splinting or casting [1][2][3][4][5]. Under some conditions, however, operation is much more preferred, as suggested by various published reports [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Open accurate reduction for irreducible mallet fractures through a new pulp traction technique with primary tendon repair

Kang

Lee

2012

Journal of Plastic Surgery and Hand Surgery

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Sixteen patients with bony mallet fingers were treated by a new technique of open reduction through a T-shaped dorsal incision and oblique wire fixation via pulp traction with additional primary extensor repair. Surgical indications included fractures with intra-articular involvement over 1/3 of the articular surface, distal phalanx subluxation, and displacement greater than 3 mm irreducible by extension block pinning. The cases were analysed prospectively for a mean follow-up period of 12 months. The results were evaluated using Crawford's criteria. Eleven cases were evaluated as excellent, three cases as good, and two cases as fair. Complications included three cases with transient nail deformity, two cases with flexion limitation of 5° and 10°, and three cases with extension lag between 5°-10°. This new method of accurate reduction achieves good clinical outcomes, with comparatively less complications in mallet fractures irreducible to closed extension block reduction.

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A Model for the Conservative Management of Mallet Finger

Cited by 37 publications

References 7 publications

Investigation of the conservative management of mallet injury in Irish acute hospitals

Investigation of the conservative management of mallet injury in Irish acute hospitals

Blinded, Prospective, Randomized Clinical Trial Comparing Volar, Dorsal, and Custom Thermoplastic Splinting in Treatment of Acute Mallet Finger

Open accurate reduction for irreducible mallet fractures through a new pulp traction technique with primary tendon repair

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