A Reiter1, M Hasan, F Unglaub, J Dreyhaupt, P Hahn. 1. Handchirurgie, Vulpius Klinik, Akademisches Lehrkrankenhaus der Universität Heidelberg, Bad Rappenau. areiter@vulpiusklinik.de
Abstract
BACKGROUND: In the treatment of the acute ligamentous mallet finger, conservative therapy with a Stack or Winterstein splint is an established approach, though there are many different conservative therapy regimes. There are even more therapy options for the chronic mallet finger (more than 4 weeks old) including different operation techniques. MATERIAL AND METHODS: In a retrospective study, 44 patients with an acute and 33 patients with a chronic ligamentous mallet finger treated with a Stack or Winterstein splint were investigated. RESULTS: The results in both groups are satisfactory (SD <10 degrees : 70.5% in the acute, 87.9% in the chronic lesions). The subjective satisfaction (scale 1-6) was high in both groups. It was even significantly higher in the group with the chronic lesions (acute: 2.55+/-1.63, chronic: 1.82+/-1.38). In both groups there was no correlation between an initially high extension deficit and a bad therapy outcome. CONCLUSIONS: Also in chronic ligamentous mallet finger, conservative therapy should be attempted before an operation, irrespective of the initial extension deficit, especially because the stress and the therapy risk for the patient with this therapy is small.
BACKGROUND: In the treatment of the acute ligamentous mallet finger, conservative therapy with a Stack or Winterstein splint is an established approach, though there are many different conservative therapy regimes. There are even more therapy options for the chronic mallet finger (more than 4 weeks old) including different operation techniques. MATERIAL AND METHODS: In a retrospective study, 44 patients with an acute and 33 patients with a chronic ligamentous mallet finger treated with a Stack or Winterstein splint were investigated. RESULTS: The results in both groups are satisfactory (SD <10 degrees : 70.5% in the acute, 87.9% in the chronic lesions). The subjective satisfaction (scale 1-6) was high in both groups. It was even significantly higher in the group with the chronic lesions (acute: 2.55+/-1.63, chronic: 1.82+/-1.38). In both groups there was no correlation between an initially high extension deficit and a bad therapy outcome. CONCLUSIONS: Also in chronic ligamentous mallet finger, conservative therapy should be attempted before an operation, irrespective of the initial extension deficit, especially because the stress and the therapy risk for the patient with this therapy is small.