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2014 ; 9
(2
): 145-50
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A prospective randomized controlled trial comparing night splinting with no
splinting after treatment of mallet finger
#MMPMID24839414
Gruber JS
; Bot AG
; Ring D
Hand (N Y)
2014[Jun]; 9
(2
): 145-50
PMID24839414
show ga
BACKGROUND: The effectiveness of night splinting after treatment of mallet finger
is unknown. We tested the hypothesis that there is no difference in extensor lag
between patients with mallet finger that wear a night splint for an additional
month after 6 to 8 weeks of continuous splinting and patients that do not wear a
night splint. METHODS: Fifty-one patients were enrolled in this randomized
controlled trial. At enrollment, range of motion was measured for the injured and
contralateral uninjured finger. The follow-up was conducted approximately 4 weeks
later in person (41 patients) or by phone (10 patients). Analysis was by
intention to treat. RESULTS: There were no significant differences in final
extensor lag between patients that did and did not receive a night splint. Among
the 41 patients with a final in-person evaluation, the final average extensor lag
was 14°, and 34 % (14 of 41 patients) had a lag of 20° or greater. Final extensor
lag correlated significantly with age, enrollment distal interphalangeal joint
(DIP) flexion and extensor lag, and final DIP flexion, with the latter two
accounting for 28 % of the variation in final lag in the final multivariable
model (p?0.001). There were no differences in disability (p?=?0.67) or
treatment satisfaction (p?=?0.48) between patients that did and did not use night
splints. CONCLUSIONS: Supplemental night splinting does not improve the outcome
of mallet finger in terms of extensor lag, disability, or satisfaction with
treatment. Patients with worse initial extensor lags should expect worse final
lags; residual lags of 20° or greater are commonplace.