Evaluation of clinical outcome of acute mallet finger deformity managed conservatively in pediatric patients

Abstract

SUMMARYObjective: We evaluated the effectivity of conservative treatment for acute mallet finger deformity in hands of pediatric patients due to trauma in this study. Method: Between 2011Between -2013 pediatric patients treated due to mallet finger deformity disturbance were reviewed retrospectively. The demographic data and the injury mechanisms of the patients were recorded. We obtained the X-ray films of the patients via PACS system. The classification was applied by the Doyle system. A standard conservative treatment protocol that maintained distal interphalangeal joint (DIP) at extension were applied to all patients. Finger splint was used during the first week for DIP extension. Then another splint that is arranged by also considering the finger diameter and made up of thermoplastic material was used to keep DIP in extension. After the treatment, the patients were clinically evaluated according to Crawford criteria. Results: 13 patients were male and 6 of them were female. 12 patients were Doyle type 1 and 7 of them were Doyle type 4a.The patients were among 9-16 ages. The mean age was 13.2. The fixation time in extension for Doyle type 1 patients was 4 weeks and was 5 weeks for the patients with Doyle type 4a. Exercise program was started fixation; splint was used one week more only at nights. Excellent results were obtained according to Crawford criteria. 2 patients experienced superficial skin problems which healed without any complication. The duration for achieving full range of motion was one week longer than the other children in three patients. Conclusion: Thermoplastic stent is an effective and easily applicable treatment method with high patient compliance for patients with acute type1 and type 4a mallet finger deformity due to trauma.Keywords: Mallet finger, pediatric patient, conservative treatment, thermoplastic splint ÖZET Amaç: Bu çalışmada, travma sonucu elde akut çekiç parmak deformitesi gelişen çocuk hastalarda konservatif tedavinin etkinliği değerlendirildi. Yöntem: Çekiç parmak deformitesi nedeniyle 2011-2013 yılları arasında tedavi edilen 19 çocuk hasta retrospektif olarak incelendi. Hastaların demografik bilgileri, yaralanma mekanizmaları kaydedildi. Hastaların grafilerine PACS sisteminden ulaşıldı. Sınıflandırma Doyle sistemine göre yapıldı. Tüm hastalara distal interfalangeal eklemi ekstansiyonda tutan standart konservatif tedavi protokolü uygulandı. İlk hafta distal interfalangeal (DİP) eklemi ekstansiyonda tutan parmak ateli ile takip yapıldı. Sonrasın da ise hastanın parmak çapına göre thermoplastik malzemeden hazırlanan yine DİP eklemi ekstansiyonda tutan splint kullanıldı. Tedavi sonrasında hastalar klinik olarak Crawford ölçütlerine göre değerlendirildi. 122 CMJ Cumhuriyet Medical JournalBulgular: Hastaların 13 tanesi erkek, 6 tanesi kadın idi. Hastaların 12 tanesi Doyle Tip I, 7 tanesi Doyle Tip IVa idi. Hastalar 9-16 yaş arasında idi. Ortalama yaş 13,2 idi. Ekstansiyonda tespit süresi Doyle Tip 1 hastalarda 4 hafta, Doyle Tip 4a hastalar da ise 5 hafta idi. Tespit sonlandır...