Materiały źródłowe

• #1 The Diagnosis and Management of Mallet Finger Injuries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5480656/

  Mallet finger injuries are frequently sustained during either work or participation in sports. […] Reaching the diagnosis of mallet finger is relatively straightforward. The main complains patients present with are pain in the affected joint, deformity, and a functional deficit. […] The history usually provides the typical mechanism of injury, ie, forced flexion or hyperextension of the distal interphalangeal joint, and physical exam will usually reveal an extension lag at the distal interphalangeal joint. […] Radiographic images of the affected finger will assess the existence of a concomitant avulsion fracture and the possibility of subluxation of the distal phalanx. […] In either case, the goal of treatment is restoring the normal joint anatomy so that the tendon can heal with minimal residual extension lag.

• #2 Mallet Finger Injuries – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459373/

  Mallet finger is the term usually applied to extensor avulsion fractures. However, this entity may also be caused by distal extensor tendon ruptures. Either one results in an inability to extend the DIP joint. […] The diagnosis of mallet finger injuries is usually a clinical diagnosis. Patients typically present with the history of a forced flexion injury. […] The diagnosis of a mallet finger is usually a clinical diagnosis. However, to distinguish between mallet finger injuries and mallet fractures, providers should obtain a three-view radiograph of the affected finger. […] The treatment for mallet fractures remains controversial. […] Surgical management is generally accepted for mallet fractures involving greater than one-third of the articular surface and for fractures with associated joint subluxation.

• #3 Mallet finger | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/mallet-finger?lang=us

  Mallet finger is an injury of the extensor mechanism of the finger at the level of the distal interphalangeal (DIP) joint. It is the most prevalent finger tendon injury in sport. It may represent an isolated tendinous injury or occur in combination with an avulsion fracture of the dorsal base of the distal phalanx. […] The preferred treatment for closed mallet injuries is non operative treatment, using a splint to maintain the DIP joint in extension or slight hyperextension; the proximal interphalangeal (PIP) joint is kept mobile. This positioning causes approximation of the injured tendon ends, which usually heals by scarring over time and restores extension. Non-operative treatment would usually involve 6 weeks of full time splinting followed by 6 weeks of night splinting. It is also important to note that the DIP joint should be kept in full extension for the entire first 6 week period including times of hygiene.

• #4 Mallet Finger – Diagnosis and Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/mallet-finger-diagnosis-and-treatment/

  The term mallet finger refers to injury of the extensor tendon of the distal interphalangeal (DIP) joint, resulting in loss of active extension of the DIP joint and a DIP joint that rests at roughly 45° flexion (1,2). […] Diagnosis of mallet finger injuries can be made with physical examination, history, and radiographs (3). […] Patients will typically present with pain in the affected joint, deformity, and an extensor deficit at the DIP joint. There is often a forced flexion or hyperextension injury of the DIP joint (3).

• #5

  https://www.orthobullets.com/hand/6014/mallet-finger

  Mallet Finger is a finger deformity caused by disruption of the terminal extensor tendon distal to DIP joint. […] Diagnosis is made clinically when the distal phalanx rests at ~45 of flexion with lack of active DIP extension. […] Imaging: Radiographs recommended views AP/Lateral of the finger. […] findings often see bony avulsion at the base of the distal phalanx. […] may be a ligamentous injury with normal bony anatomy. […] assess for distal phalanx subluxation.

• #6 Mallet finger

  https://www.pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Mallet-finger

  To guide PCH Emergency Department (ED) staff with the assessment and management of mallet finger. […] Pain, swelling (+ / bruising) on the dorsum of the DIP joint. […] Flexed posture of finger tip due to inability to actively extend it. […] Passive (by the examiner) extension is usually possible. Inability to extend DIP passively indicates bony or soft tissue entrapment. […] The degree of DIP angulation often reflects the severity of the tendon disruption. […] Request a finger X-ray of the affected digit. This should have PA (posterior-anterior), oblique, and lateral views. […] Look for a dorsal avulsion fracture of the distal phalanx at DIP joint. […] Call plastics registrar for review and fast the child for possible surgery. […] Preferred splint – Stax splint (see below) […] Alternative splint – Zimmer splint (see below ) if unable to find a suitable size Stax splint or unavailable. […] Both splints are designed to splint the DIP joint in hyper-extension but permit PIP joint movement. […] Instruct the patient / family to not remove the splint, as even brief DIP joint flexion can delay healing and impair final joint function. […] Follow up Plastics Clinic in 1 to 2 days time.

• #7 Mallet Finger – Injuries; Poisoning – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/injuries-poisoning/sprains-and-other-soft-tissue-injuries/mallet-finger

  Mallet finger can usually be diagnosed by examining the finger. […] Anteroposterior, lateral, and usually oblique x-rays are taken. A fracture, if present, is usually visible on the lateral view. X-rays may be normal if only the tendon is torn.

• #8 Mallet Finger – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/sprains-and-other-soft-tissue-injuries/mallet-finger

  Mallet finger usually results when the tendon that attaches bone to muscle in the fingertip is torn. […] Doctors can usually diagnose mallet finger when they examine the finger. […] X-rays are usually taken at several different angles to check for a fracture.

• #9 Mallet Finger Texas: Causes, Symptoms & Treatment | OrthoTexas

  https://www.orthotexas.com/mallet-finger-causes-symptoms-and-treatment/

  Mallet Finger test may be conducted to diagnose the condition. In this, the orthopedic doctor holds the affected finger and asks the patient to straighten it without using the other hand. […] X-rays may also be conducted to determine any misalignment in the bones of the joint. […] However, delayed diagnosis and treatment may hamper the healing process and, in some cases, lead to permanent deformity of the affected finger.

• #10 Mallet Finger – AOA Orthopedic Specialists

  https://www.arlingtonortho.com/conditions/hand-and-wrist/mallet-finger/

  A common injury in orthopedics occurring in the hand, mallet finger happens when the extensor tendon has damage at the tip of the finger. […] To diagnose mallet finger, the physician starts with a physical examination. During a physical examination, the orthopedic hand specialist asks the patient about their medical history and inquires about their everyday lifestyle. […] The “mallet finger test” occurs when a physician asks the patient to straighten their finger on their own. To confirm the diagnoses, the physician uses diagnostic testing. Diagnostic testing can also rule out any torn ligaments, fractures, or other potential injuries to the finger. […] Mallet finger injuries that patients leave untreated often result in further injury. […] Most mallet finger injuries do not require surgical intervention, However; patients should always seek treatment from an orthopedic physician.

• #11 Mallet Finger (Drop Finger, Baseball Finger) – observation | Hand Surgery Resource

  https://www.handsurgeryresource.net/mallet-finger-obs

  Examination of the extensor tendons is a long-established component of the routine clinical examination of the hand. […] The exam is used in the diagnosis of mallet finger, as well as in Kirners deformity, Dupuytrens disease, certain injuries to the digits, rheumatoid arthritis and a variety of other diseases, disorders and conditions. […] The patient is examined for a finger with extension lag at the distal interphalangeal joint. […] The distal interphalangeal joint is also examined for tenderness dorsally. […] Findings from the history and physical examination define the condition. Therefore, a condition that meets the criteria described in the Instructions section above, by definition, has a sensitivity (true positive rate; proportion of actual positives that are correctly identified as such) and specificity (true negative rate; proportion of actual negatives that are correctly identified as such) of 100%.

• #12 Mallet Finger Workup: Radiography

  https://emedicine.medscape.com/article/1242305-workup

  Posteroanterior (PA) and lateral radiographs centered at the distal interphalangeal (DIP) joint of the affected finger are required. […] These radiographs are used to differentiate between a bony mallet injury and a tendinous one. […] They also reveal any associated metaphyseal, shaft, or tuft fractures of the distal phalanx. […] Perhaps most important, lateral radiographs reveal the presence of volar subluxation of the distal phalanx. […] In addition, these radiographic views reveal rare condylar fractures of the middle phalanx. […] Radiographs of the whole hand do not suffice in the evaluation of mallet finger, because parallax of the x-ray beams creates an uninterpretable oblique view of the DIP joint. […] No imaging studies other than radiography are indicated in mallet finger.

• #13 Mallet Finger: Causes, Symptoms, and Treatment

  https://www.healthline.com/health/mallet-finger

  Your doctor will be able to diagnose mallet finger by examining your dropped fingertip. […] They may order an X-ray and possibly an MRI or ultrasound to see the extent of the injury to your tendon and bone. […] An X-ray will show the rupture of the tendon, any bone fracture, and whether the bone is out of alignment. […] The ultrasound and MRI are more sensitive in imaging bone fragments that may be involved.

• #14 Mallet Finger Treatment Enid, OK | Finger Joint Deformity Treatment Alva, OK

  https://www.nwooc.com/mallet-finger-orthopaedic-surgeons-ok.html

  The diagnosis of mallet finger involves a physical examination and obtaining an X-ray of the injured finger. […] In some cases, other imaging techniques such as MRI scan may be ordered.

• #15 The Role of High Frequency Ultrasonography in Diagnosis of Acute Closed Mallet Finger Injury | Scientific Reports

  https://www.nature.com/articles/s41598-017-10959-x

  To evaluate the role of high frequency ultrasonography in diagnosis of acute closed mallet finger injury. […] High frequency ultrasonography could be an accurate, reliable, and non-invasive diagnostic imaging method in diagnosis of acute close mallet finger injury. […] The purpose of this study was to observe the clinical application and usage of high frequency ultrasonography in the diagnosis of acute closed mallet finger injury, compared to that of X-ray and MRI examination. […] This study proved that both ultrasonography and MRI were useful in the diagnosis of mallet finger injury with high accuracy, reliability, and safety. […] In bony mallet fingers(type A), although ultrasonography is inferior to X-ray and MRI in demonstrating a volar subluxation of distal phalanx, ultrasonography was more sensitive and accurate in showing bony fragment compared to MRI. […] High frequency ultrasonography can be used as an accurate, reliable, and non invasive diagnostic imaging method in the assessment of both bony and tendinous mallet finger injury.

• #16 The utility of ultrasound in the mallet finger deformity diagnosis

  https://www.medigraphic.com/cgi-bin/new/resumenI.cgi?IDARTICULO=28699

  The physical examination diagnoses mallet finger deformity, but cannot determine internal damage. […] Ultrasound has been used for the diagnosis of tendon injuries. […] Ultrasound is a dynamic medium that allows for exploration of the damaged tendon during finger flexion and extension and is the procedure that could detect the most changes in this type of deformity. […] Ultrasound had the highest sensitivity for the diagnosis of mallet finger deformity; furthermore, it is simple, noninvasive, economical and accessible, causes no damage and can be performed in all patients in the emergency ward. […] It determines with certainty the internal damage of the deformity, identifies the specific conditions of the extensor tendon and all the surrounding tissue, including bones and joints.

• #17 Mallet Finger New York, NY | Mallet Finger Surgery Smithtown, Long Island, NY

  https://www.koteplasticsurgery.com/mallet-finger-plastic-reconstructive-surgeon-smith-town-long-island-ny/

  The diagnosis of mallet finger involves a physical examination and obtaining an X-ray of the injured finger. In some cases, other imaging techniques such as MRI scan may be ordered. […] If left untreated, mallet finger can develop into a finger joint deformity referred to as a swan neck deformity.

• #18 Mallet Finger: Symptoms & Treatment | The Hand Society

  https://www.assh.org/handcare/condition/mallet-finger

  Medical attention should be sought within the first few days after the injury, especially if there is blood beneath the nail or if the nail is detached at the base. This may be a sign of a nail bed injury or an open (compound) fracture. […] X-rays or ultrasound images can be used to show if there is a fracture causing the finger deformity. CT scans may be ordered if there are many fracture fragments. The fracture may be only at the tip of the bone at the attachment site. But sometimes, the fracture disrupts the structure of the joint. In children, the fracture may be in the growth part of the bone. […] Mallet fingers with exposed bone or with a cut tendon should be treated urgently to prevent infection. […] If a mallet finger is not treated promptly, the finger may not function properly and may cause pain. Continued pain and repeated injuries are more likely due to a problem in the joint. Usually, this is due to a poorly aligned joint fracture. Over time, arthritis can develop.

• #19 The Diagnosis and Management of Mallet Finger Injuries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5480656/

  Nonoperative management has been suggested as first-line treatment option for almost all mallet finger injuries. […] It is currently considered the standard of care for all injuries with no associated fracture, no volar subluxation of the distal phalanx, or cases with involvement of less than one-third of the articular surface. […] Despite the many different types of splints available for the management of mallet finger injuries, none has been proven to be superior to another. […] Although nonoperative management appears to be the mainstay of treatment for closed injuries only involving the extensor tendon, surgery does have a role in cases of patients with poor compliance to continuous splinting or certain professionals (musicians, surgeons). […] In those cases, the distal interphalangeal joint is fixed in extension using a K-wire, which is removed after 8 weeks to be followed by 2 weeks of external splinting during nighttime.

• #20 Extensor tendon injury of the distal interphalangeal joint (mallet finger) – UpToDate

  https://www.uptodate.com/contents/extensor-tendon-injury-of-the-distal-interphalangeal-joint-mallet-finger

  Extensor tendon injury of the distal interphalangeal joint (mallet finger) […] The presentation, diagnosis, and management of mallet finger injuries are reviewed here. […] Mallet finger injuries are often categorized as tendinous or bony injuries, the former limited to tendon tears and the latter involving a fracture of the proximal portion of the distal phalanx. […] The injury is usually caused by a direct blow to the tip of the finger, such as when a ball strikes the fingertip or the fingertip strikes a rigid surface. […] This can cause forceful flexion of the distal interphalangeal (DIP) joint, leading to a tear in the extensor tendon near its insertion on the distal phalanx. […] A high-velocity axial load may also produce a forceful extension of the DIP joint, causing a bony fracture of the distal phalanx. […] Lower velocity flexion forces, such as might be involved in changing bed linens, can produce tendinous mallet finger injuries in older adults with weakened tissue.

• #21 The Diagnosis and Management of Mallet Finger Injuries

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5480656/

  In the case of mallet finger associated with an underlying distal phalanx fracture, surgery is recommended if the fracture involves more than 30% of the articular surface or if there is palmar subluxation of the distal phalanx. […] Surgical interventions often have a high incidence of complications while nonoperative management has been found to result in minimal functional impairment of the affected joint.

• #22 MALLET FINGER – Texas Orthopedic and Spine Associates

  https://txosa.com/mallet-finger/

  Additionally, the primary indicators for diagnosing mallet finger include deformity, pain, and functional impairment in the affected finger joint. […] Patient history often provides insights into the injury’s mechanism. […] Radiographic imaging helps assess the possibility of distal phalanx subluxation or accompanying avulsion fracture. […] Extension lag remains the main functional deficit. […] Seymour fractures, a consideration in infant patients, involve open distal phalangeal fractures with nail bed laceration and potential interposition of the germinal matrix. […] Seymour fractures appear extra-articular on imaging, with physis widening and variable metaphysis-epiphysis displacement.

• #23 Mallet Finger: What It Is, Complications & Recovery Time

  https://my.clevelandclinic.org/health/diseases/21825-mallet-finger

  Mallet finger occurs when the tip of your finger droops downward. An injury to your extensor tendon causes it. […] If you’ve injured your finger and can’t move it normally, see a healthcare provider. They’ll ask about the injury and examine your finger. Then, they’ll take images of your finger to assess the damage and determine what kind of treatment you’ll need. […] Most mallet fingers won’t need surgery. But you might need surgery if you have a complicated fracture or your tendon is torn all the way through. It’s best to have your injury checked out right away so you know how serious it is. If you’re going to need surgery, it’ll be best to have it as soon as possible. […] Most mallet finger injuries will heal if you wear a finger splint to keep it in the right position. You’ll wear it for at least six to eight weeks, and often longer, day and night. Your healthcare provider will show you how to clean and care for it. They might want to take some X-rays in a few weeks to check how it’s healing.

• #24 Mallet Finger – Merrimack Valley Orthopaedic Associates

  https://www.mvoa.us/our-services/hand-wrist/mallet-finger/

  While a mallet finger is typically easy to diagnose upon physical examination, in most situations, the doctor has X-rays taken to rule out other injuries, such as a bone fracture or joint misalignment. […] When X-rays detect a fracture, surgical intervention may be necessary, but usually only if : […] The doctor should be consulted if pain worsens, skin color changes, numbness or tingling occurs, or the finger remains swollen after treatment has been completed.

• #25 Mallet Finger Westchester county – Baseball Finger Harrison

  https://specialtyorthony.com/conditions/hand-wrist-conditions/mallet-finger/

  While a mallet finger is typically easy to diagnose upon physical examination, in most situations, the doctor has X-rays taken to rule out other injuries, such as a bone fracture or joint misalignment. […] When X-rays detect a fracture, surgical intervention may be necessary, but usually only if : […] Rarely, patients who suffer this injury may develop an infection or other complication. The doctor should be consulted if pain worsens, skin color changes, numbness or tingling occurs, or the finger remains swollen after treatment has been completed.

• #26 Mallet Finger: Symptoms & Treatment | The Hand Society

  https://www.assh.org/handcare/condition/mallet-finger

  If splinting is not started for several weeks after injury, the result is less satisfactory but can still be successful. […] Your surgeon or hand therapist will provide instructions on how to wear the splint. They will show you exercises to maintain motion at the middle joint while the end joint is held still. Once the mallet finger has healed, your surgeon or hand therapist will teach you exercises for the small end joint as it becomes very stiff from the splinting. Typically, the finger regains acceptable function and appearance with this treatment. However, some slight droop, bumpiness, or contour difference in this finger can be permanent. […] Surgery may be considered when a mallet finger injury has a large bone fragment or the joint is not properly aligned. In these cases, wires or small screws are used to realign the joint.

• #27 Mallet finger | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/mallet-finger?lang=us

  It is uncommon for closed mallet finger injuries to require surgical intervention. Surgery is considered for avulsion fracture where the fragment is larger than 1/3 of the joint surface and there is more than 2 mm displacement, or there is volar subluxation of the distal phalanx which is not reducible in a splint.

• #28 Mallet Finger | Precision Surgery Center, Orthopedic, Spine & Pain Management, Macomb, MI

  https://www.precisionsurgerycenter.org/mallet-finger-orthopedic-spine-surgeon-macomb-michigan/

  If you fail to achieve adequate relief, you will be recommended surgery that involves repairing the torn tendon. If the mallet finger involves a fracture of the bone fragment, then it can be stabilized and fixed using pins and a special K-wire. […] After mallet finger surgery, you will be recommended for physical therapy or occupational therapy for flexibility and strengthening exercises.

• #29 Mallet Finger: What It Is, Complications & Recovery Time

  https://my.clevelandclinic.org/health/diseases/21825-mallet-finger

  Most fingers recover from mallet finger injuries, as long as they get treatment soon enough. After splinting and some hand therapy, you should be able to straighten your fingertip again. Sometimes, it remains a little bit bent, or there’s a bump on the underside of the joint, but it still functions normally.

• #30 Treatment for Mallet Finger | Will I Need Surgery? | Orthopedic Institute of NJ

  https://orthopedicnj.com/news/treatment-for-mallet-finger

  The main symptom of this injury is the inability to straighten your finger. […] A specialist will take an x-ray to evaluate for fracture. […] If the joint looks dislocated, surgery is needed to treat it. […] Yes, a mallet finger can heal without surgery but will need immobilization in the form of a stax splint, alumafoam splint, or a figure-of-8 splint. […] Its important to understand that, unless you take this seriously, a mallet finger can permanently deform the finger. […] Surgery is a rare treatment for mallet finger, and usually involves pins to keep the DIP joint immobilized in extension, or possibly some hyperextension, until the tendon or bone heals. […] If theres a large avulsion fracture. […] Theres an extensive tendon injury. […] Theres joint subluxation or dislocation. […] Conservative treatment failed. […] Mallet finger is chronic. […] Ultimately, treatment for a mallet finger is usually very easy but annoying – finger splint for 6-to-8 weeks.

• #31 Mallet Finger Diagnosis and Treatment – Dr Anzarut Plastic Surgery

  https://dranzarut.com/hand/mallet-finger-diagnosis-and-treatment/

  A mallet finger occurs when the tendon responsible for straightening the last finger joint, also called the DIP joint as seen here in this picture, is injured. […] A mallet finger is treated by bringing the tendon ends back together to allow those two ends of the tendons to heal. […] The ends must be in contact for approximately 12 weeks. […] A splint is used to hold the finger joint straight and bring the tendon ends together. […] If a splint is left on or the foam on the splint becomes wet and sits against the skin, one may develop an ulceration as seen in this picture. […] The tips should be straight. […] Full recovery often will take six to 12 months until that tightness goes.

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