Mallet finger, also called drop or baseball finger, is where the end of a finger cannot be actively straightened out due to injury of the extensor tendon mechanism. Treatment commonly involves splintage of the finger for six or more weeks. Less frequently, surgical fixation is used to correct the deformity.
To examine the evidence for the relative effectiveness of different methods of treating mallet finger injuries.
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (March 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 1), MEDLINE (1966 to March week 1 2008), EMBASE (1988 to 2008 week 11), other databases, reference lists of articles and various conference proceedings.
Randomised or quasi-randomised clinical trials evaluating different interventions, including no intervention, for treating mallet finger injuries.
Data collection and analysis
Both authors independently performed study selection, quality assessment and data extraction. Study authors were contacted for additional information.
Four trials were included. These involved a total of 278, mainly adult, participants with 283 mallet finger injuries. All four trials were methodologically flawed, including inadequate outcome assessment.
Three trials compared different types of finger splints versus a standard Stack splint. One trial found a lower incidence of treatment failure in participants treated with a perforated custom-made splint. One trial found there were fewer complications in participants treated with a padded aluminium-alloy malleable finger splint; however, the incidence of treatment failure was similar in the two treatment groups. One trial evaluating the Abouna splint found a similar incidence of treatment failure in the two groups. However, the Abouna splint often needed replacing due to disintegration of its rubber cover and rusting of the exposed wires and was also less popular with participants.
The fourth trial found no statistically significant differences between participants whose mallet finger was treated with Kirschner wire fixation and those with a Pryor and Howard splint. Similar numbers had complications in the two groups.
There was insufficient evidence from comparisons tested within randomised controlled trials to establish the relative effectiveness of different, either custom-made or off-the-shelf, finger splints used for treating mallet finger injury. There was a useful reminder that splints used for prolonged immobilisation should be robust enough for everyday use, and of the central importance of patient adherence to instructions for splint use. There was insufficient evidence to determine when surgery is indicated.
我們檢索了Cochrane Bone, Joint and Muscle Trauma Group Specialised Register(2005年6月)，the Cochrane Central Register of Controlled Trials (The Cochrane Library 第2期，2005)，MEDLINE(1966年至2005年6月第一週)，EMBASE(1988至2005年第24週)，其他數據庫，參考文獻目錄和各種會議記錄。
4個試驗被納入。總共278個患者，主要是成人，總計283隻槌狀指。四個試驗各有方法論上的存在缺陷，包括缺乏比較不適當的結果評估。三個試驗比較不同類型手指副木與標準Stack副木的療效。其中一個試驗發現使用客製化副木有較低的失敗率。另一個試驗發現使用墊鋁合金可塑性手指副木併發症較少，然而，失敗率兩組治療組是相似的。最末個試驗發現Abouna副木與標準Stack副木失敗率相當,且前者往往需要更換，由於它橡膠蓋的解體和生鏽的外露電線,較不受參與者青睞。 第四個試驗發現用Kirschner wire固定或Pryor及Howard副木治療無統計上差異,且兩組併發症數相當。
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。