Orthopaedic Hand Trauma CH32 (1)
SECTION 3 | Tendon Injuries
■ ■ Acute open mallet finger— For a purely tendinous mallet, a combina- tion of irrigation and debridement with primary tendinous repair and primary closure is indicated. If primary repair of the extensor tendon cannot be achieved, the tendon may be sutured incorporating the skin (tenodermodesis) or can be reconstructed with tendon graft in a primary or delayed fashion. The patient is then splinted in DIP joint extension postoperatively.
CRPP vs ORIF for distal phalangeal volar subluxation, inability to tolerate splinting, >50% of articular surface involved, or >2mm of articular step-off
Splinting for 6-8 wk for acute (less than 12 wk) soft tissue injury or non- displaced bony mallet injury.
2-4 wk of nighttime splinting
Primary Operative Repair
Antibiotics, irrigation/ debridement, and splinting
SUGGESTED READINGS Alla SR, Deal ND, Dempsey IJ. Current concepts: mallet finger. Hand . 2014;9:13-44. Botero SS, Hidalgo Diaz JJ, Benaida A, Collon S, Facca S, Liverneaux PA. Review of acute traumatic closed mallet finger injuries in adults. Arch Plast Surg . 2016;43:134-144. Cheung JPY, Fung B, Ip WY. Review of mallet finger treatment. Hand Surg . 2012;17(3):439-447. Wehbe MA, Schneider LH. Mallet fractures. J Bone Joint Surg Am . 1984;66(5): 658-669.
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