Article

OBJECTIVE: To compare Stack, dorsal, and custom splinting techniques in people
with acute type 1a or b mallet finger. DESIGN: Multi-center randomized controlled
trial. SETTING: Outpatient hand therapy clinics (2 public hospitals and 1 private
clinic). PARTICIPANTS: Patients (N=64) with acute type 1a or b mallet finger.
INTERVENTIONS: Prefabricated Stack splint (control), dorsal padded aluminum
splint, or custom-made thermoplastic thimble splint.
All were worn for 8 weeks
continuously, with a 4 week graduated withdrawal and exercise program. MAIN
OUTCOME MEASURES: The primary outcome was extensor lag at 12 and 20 weeks.
Secondary outcomes were incidence of treatment failure, complications, range of
motion of the distal interphalangeal joint, pain (visual analog scale) patient
compliance, and patient satisfaction. RESULTS: There was no difference in the
primary outcome between groups at 12 or 20 weeks; however, the Stack and dorsal
splints had significant rates of treatment failure (23.8% in both groups,
compared to none in the thermoplastic group; P=.04). There was a medium negative
correlation between patient compliance and degree of extensor lag. No significant
differences between groups were observed for patient satisfaction or pain.
CONCLUSIONS: As splints for mallet finger must be worn continuously for 6 to 8
weeks, and compliance correlates with favorable outcomes, treating practitioners
must ensure the splint provided is robust enough for daily living requirements
and does not cause complications, which are intolerable to the patient. In this
study, no extensor lag difference was found between the 3 splint types, but
custom-made thermoplastic splints were significantly less likely to result in
treatment failure.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS