Travmatologiâ i Ortopediâ Rossii (Dec 2022)
Management of Mallet Finger: Current Status (Review)
Abstract
Background. Often, an incorrect treatment tactic injuries of the mallet finger can cause a pronounced dysfunction of the finger. In addition, remaining finger deformation can significantly reduce the aesthetic satisfaction of the patient. The relevance of the problem of this injury type can be mainly explained by the lack of a unified algorithm for choosing treatment tactics, and, as a result, a high percentage of unsatisfactory clinical results. Review purpose to assess the current state of the problem and the effectiveness of the proposed methods of treatment of mallet finger based on the analysis of the literature Results. The lack of a single protocol for the treatment of mallet finger leaves the question of choosing the optimal tactics open. The variability of interventions and indications for their implementation force specialists to rely on their own empirical experience when determining tactics in each clinical case. The search continues for the optimal type of suture and methods of immobilization with a closed injury in the Zone I to improve clinical results and minimize the risk of potential complications. The proposed modifications of blocked osteosynthesis have their own advantages, however, they require future studies on a larger cohort of patients to confirm their effectiveness. Various internal implants that allow to achieve anatomical reposition require additional studies due to the high risk of complications and insufficient stability of fixation. The obtained data are not enough to make a reasonable decision on the choice of the optimal method of treating the pathology in question. Along with a high percentage of complications, these factors significantly worsen the functional outcomes of treatment. Conclusion. Literature analysis shows that there is an active search for new surgical methods for the treatment of mallet finger injuries among both Russian and foreign specialists. The data obtained are not enough to make a reasonable decision on the choice of the optimal method of treating the pathology in question, since the results of the studies carried out are rather contradictory or require verification. This determines the need to improve treatment concepts with the elimination of existing shortcomings in order to create a well-founded algorithm for choosing a rational technique.
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