Clinical commentary in response to 'effectiveness of cast immobilization in comparison to the gold-standard self-removal orthotic intervention for closed mallet fingers: A randomized clinical trial'

摘要

Patients with closed Zone I extensor tendon injuries, with or without intra-articular distal phalanx fracture, benefit from conservative management consisting of an orthotic immobilizing the distal interphalangeal joint (DIPJ) in extension, which is worn full time for 6 to 8 weeks followed by progressive flexion. In general, treatment goals are to minimize extensor lag, optimize DIPJ flexion, and avoid skin complications. However, it is not uncommon for patients to have an extension lag and experience DIPJ flexion impairment following treatment, In addition, maceration and skin breakdown may be caused by prolonged orthotic contact with volar skin.Materials used to immobilize the DIPJ may affect outcome as patient compliance depends on orthotic comfort, appearance, and convenience.