Mallet Finger of Bony Origin

Mallet Finger of Bony Origin
This is less common. It is usually fixed with K-wire,
if more than one-third of the dorsal articular surface
is involved and if remainder of the distal phalanx is
subluxated volar-wards.
Facts about Mallet Splints
In these cases, proximal interphalangeal joint of the finger
is not immobilized but only the distal joint is immobilized
by using:

a. Simple volar unpadded aluminum splint, which provides
three-point pressure.
b. Dorsal padded aluminum splint.
c. A stack plastic mallet finger splint
Distal joint is put in slight hyperextension. The splint
may cause pain and the amount of hyperextension
should not cause blanching of the skin over DIP joint.
Splints are useful in cooperative patients, and in
uncooperative patients. Smellie’s cast is used. About 6
to 10 weeks of continuous immobilization is required.
K-wire fixation is considered in patients like dentist or
surgeon who wants to return to work quickly.
Lesser-Known but Important Thumb Injuries
• Bowler’s Thumb: It is a traumatic neuropathy of the
digital nerve of the thumb due to repeated friction from
gripping a ball.
• Game Keeper’s or Baseball Thumb: This has been
explained earlier.
DISTAL INTERPHALANGEAL JOINT INJURIES
These injuries are usually due to ball catching sports.
Salient Features
• Pure dislocations without tendon ruptures are
rare.
• Most of the times DIP joint dislocations are
missed initially.
• Dislocation is mainly dorsal.
• Isolated injury to the collateral ligament and volar
plate are rare.
Jersey finger: It is due to avulsion of flexor digitorum
profundus from its insertion on distal phalanx. This
is the opposite of ‘mallet finger’ and the patient is
unable to flex the distal interphalangeal joint. It is
seen in football and rugby players.