The Orthobullets Podcast Core⎪Hand⎪Mallet finger
Nov 17, 2024
Dive into the world of mallet finger—a finger injury that leaves the distal phalanx in a curled position. Discover the different types and classifications, including Doyle's insightful typology. Learn about the effective nonoperative splinting techniques and when surgical options come into play. The hosts dissect the outcomes of treatment methods and the functional consequences of this injury. Plus, they tackle intriguing clinical questions regarding acute management. It’s a comprehensive guide for every orthopaedic curious mind!
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Definition And Classic Exam
- Mallet finger results from disruption of the terminal extensor tendon distal to the DIP joint.
- The classic exam shows the distal phalanx resting in ~45° flexion with absent active DIP extension.
Typical Mechanism Of Injury
- The typical mechanism is a sudden forced flexion to a fully extended fingertip, often from ball sports.
- Less commonly it's a sharp or crushing dorsal DIP laceration causing the same extensor disruption.
Doyle Classification Overview
- Doyle's classification separates closed, open, and fracture-associated mallet injuries into types 1–4 with subtypes for fractures.
- Type 4 subdivides pediatric physial injuries and fracture fragments by articular involvement (<20%, 20–50%, >50%).