Mallet finger injury no splint treatment by hand exercises. V. Macionis

This video illustrates mallet finger non-splint treatment with an exercise technique developed by Valdas Macionis, MD, PhD. The technique is based on frequent hold-relax tip-to-tip power pinch exercises. Splint and surgery related problems can be avoided. Complete or almost complete recovery of extension can be achieved. The technique does not preclude further splinting or surgical tendon repair.

Mallet finger is a deformity caused by traumatic loss of continuity between the extensor apparatus and the distal phalanx. The injury may involve just the terminal extensor tendon or phalangeal bone fracture with or without wound. Untreated mallet finger may result in stiffness and osteoarthritis of the distal interphalangeal (DIP) joint and secondary swan-neck deformity (hyper-extension at the proximal IP joint and flexion at the DIP joint). The standard conservative and surgical treatments, all involving immobilization of the DIP joint in extension, are associated with frequent complications including deficit in range of motion of the DIP joint and soft tissue problems. It has been shown that splinting is effective at a considerable time after closed non-fracture mallet injury. Therefore, it is clinically sound to attempt treatment by exercises before proceeding to the immobilization methods. Treatment by exercises should be especially useful for old mallet deformities with stiffness of the DIP joint. The possible mechanism of the treatment may involve elongation of the central extensor slip and proximal slide of the digital extensor apparatus.

 

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