Sage Journals: Discover world-class research

Abstract

A case report of a 46-year-old female physiotherapist who sustained a right middle finger tendinous mallet injury, while adjusting a pillow under a patient in the intensive care unit (ITU) is described below. Initial treatment consisted of immobilisation of the distal interphalangeal (DIP) joint in slight hyperextension 24 hours a day for eight weeks. Ten days after reduction in splint-wearing time, a 15° extension lag developed at the DIP joint, which was actively correctable with hyperextension of the proximal interphalangeal (PIP) joint. Blocked strengthening of the terminal extensor tendon combined with prevention of hyperextension at the PIP joint resulted in a good outcome. Considerations for practice including prolonged splint protection and graded exercise programmes for tendinous mallet injuries and suggestions for splinting combined mallet and swan neck deformities are discussed.

Get full access to this article

View all access options for this article.

References

Bendre-Anup

, Hartigan

, and Kalainov

(2005). ‘Mallet Finger’, The Journal of the American Academy of Orthopaedic Surgeons 13 (5): 336–344.

Benyon

(2001). ‘A review of the treatment for mallet finger injuries’, Clinical Interest Group in Orthotics, Prosthetics and Wheelchairs (CIGGOPW) News. 43:4.

Boardman

, and Salter

(2000). ‘Specific conditions and injuries’, in: Salter

, and Cheshire

(Eds) Hand Therapy Principles and Practice, chapter 7, 140–180. First Edition. Reed Educational and Professional Publishing, Oxford.

Boscheinen-Morrin

, and Conolly

(2001). The Hand, Fundamentals of Therapy, chapter 4. Third edition. Elsevier Limited, London.

Flemming

(1998). ‘The anatomy of the proximal interphalangeal joint and the extensor mechanism of the finger’, The British Journal of Hand Therapy 3 (4): 4–8.

Katsoulis

, Rees

, and Warwick

(2005). ‘Hand therapist-led management of mallet finger’, The British Journal of Hand Therapy 10 (1): 17–20.

Meals

(2006). ‘Mallet Finger’, www.eMedicine.com/orthoped/topic413.htm. (last updated 17 October 2007)

Okafor

, Mbubargbu

, Munshi

, and Williams

(1997). ‘Mallet deformity of the finger: Five-year follow up of conservative treatment’, The Journal of Bone and Joint Surgery 79-B(4):544–7.

Pratt

(2004). ‘Is eight weeks immobilisation of the distal interphalangeal joint adequate treatment for acute closed mallet finger injuries on the hand? A critical review of the literature’, British Journal of Hand Therapy 9 (1): 4–10.

10.

Robinson

(2005). “Mallet Fracture’, www.eMedicine.com/sports/topic72.htm.

11.

Rockwell

, Butler

, and Byrne

(2000). ‘Extensor tendon: Anatomy, Injury and reconstruction’, Plastic and Reconstructive Surgery 106 (7): 1592–1603.

12.

Rosenthal

(2002). The extensor tendons, in: Mackin

, Callahan

, Skirven

, Schneider

, Osterman

, and Hunter

(eds 2002). Rehabilitation of the Hand and Upper Extremity. Chapter 30, pp 498–541. Fifth edition, Mosby, St Louis.

13.

Tuttle

, Olvey

, Stern

(2006). ‘Tendon avulsion injuries of the distal phalanx. Clinical Orthopaedics and Related Research’, 445:157–168.

A Mallet Injury Case Study with Recommendations for Practice

Abstract

Get full access to this article

References