Commentary on article 'effectiveness of cast immobilization in comparison to the gold-standard self-removal orthotic intervention for closed mallet fingers: A randomized clinical trial' (Tocco et al., 2013)

摘要

Dear Editor: The article titled "Effectiveness of cast immobilization in comparison to the gold-standard self-removal orthotic intervention for closed mallet fingers: A randomized clinical trial" published in the March 2013 Journal of Hand Therapy describes a well designed and analyzed study with a new alternative to the treatment of mallet finger, a common diagnosis seen in most hand clinics. We agree with the authors that "conservative treatment through orthotic (splint) immobilization has gained favorable recognition over surgical approaches for closed tendinous or bony mallet injuries (Type1)" as cited in ref. 1 (p. 1). While this concept appears to be true, persons with certain occupations may benefit from a buried percutaneous pin as an "internal orthosis" which is different from the typically described surgical interventions.4 In the article, the authors hypothesized correctly that outcomes would improve if patients were not required to remove their orthosis for cleansing (p. 2). An "internal orthosis" of a pin would also serve this same purpose. Some occupations that may benefit from this treatment option in addition to a traditional orthosis or cast would be surgeon, veterinarian, dentist, or musician.