Is Eight Weeks' Immobilisation of the Distal Interphalangeal Joint Adequate Treatment for Acute Closed Mallet Finger Injuries of the Hand? A Critical Review of the Literature

Abstract

The evidence for the period of splint immobilisation for mallet finger injuries was systematically reviewed in order to establish if eight weeks of distal interphalangeal joint immobilisation was adequate treatment for acute closed injuries and hence to develop a more evidence-based treatment regime. Databases were searched and relevant studies identified using a list of keywords. All articles reporting outcomes from the use of splints in the conservative treatment of acute closed mallet finger injuries published between January 1981 and December 2001 were included in this review. A total of nine papers met the inclusion criteria and were reviewed using a critical appraisal checklist. No randomised controlled trials were found. There was a lack of consistency in the treatment immobilisation period and evaluation outcomes, which made direct comparison of data impossible. The lack of robust evidence does not allow us to establish if an eight-week immobilisation period using a dorsal splint with the distal interphalangeal joint in extension is best practice. However, most papers advocate a regime to minimise skin complications and that additional protection at night following the immobilisation period is important.