Casting orthosis for mallet finger yielded fewer skin complications vs splint
Results showed an association of fewer skin complications and less orthotic-related pain with use of a casting orthosis for mallet finger immobilization compared with a traditional thermoplastic splint.
Michael Rivlin, MD, FAAOS, and colleagues randomly assigned 58 patients with acute bony or soft tissue mallet finger to be treated with immobilization with either a thermoplastic, custom fabricated splint or a casting orthosis (QuickCast, Rolyan). Researchers evaluated patients at 3, 6 and 10 weeks for acute bony mallets and at 4, 8 and 12 weeks for soft tissue mallets. At each follow-up visit, patients and the treating physicians completed evaluation forms, and researchers compared skin complications, pain with orthosis, compliance and final extensor lag between the two groups.
Regardless of whether a patient had a bony or soft tissue mallet injury, results showed patients treated with the casting orthosis had fewer skin complications and less pain compared with the thermoplastic, custom fabricated splint group. Subgroup analysis results showed an even greater difference in perceived pain, favoring the casting orthosis over the splint group among patients with soft tissue mallet finger. Researchers found no significant differences with cast/splint care difficulty and wear pattern or in final extensor lag between the use of the casting orthosis and the splint. Physicians reported no significant differences in skin complications, patient complaints or final extensor lag between the casting orthosis and splint groups, according to physician survey data.
“Overall, QuickCast immobilization for the treatment of acute soft tissue and bony mallet fingers seems to be more comfortable and is associated with fewer skin complications than fabricated splints likely due to its better fit, subsequently keeping patients more compliant with its use,” Rivlin, hand and wrist surgeon at Rothman Orthopaedic Institute, told Healio Orthopedics. “QuickCast for the treatment of bony and soft tissue mallet injuries is effective and preferred by most patients compared to thermoplastic splints.” – by Casey Tingle
Cavanaugh PK, et al. ePaper 460. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2020 (meeting canceled).
Disclosure: Rivlin reports he is a board or committee member for the American Society for Surgery of the Hand; is on the editorial or governing board for Archives of Bone and Joint Surgery, HAND and Journal of Hand Surgery – American; has stock or stock options in Dimension Orthotics; receives IP royalties and is a paid consultant for Miami Device Solutions; and is a paid presenter or speaker for Seg-way.