Curative effect of conservative versus surgical treatment for tendinous mallet finger deformity and its influencing factors

  Objective  To compare the clinical effect of conservative treatment and surgical treatment of mallet finger and to analyze the factors affecting the treatment effect.

  Methods  A total of 108 cases with tendinous mallet finger deformity were collected and divided into conservative treatment group(n=54) and surgical treatment group(n=54) according to treatment methods. The conservative treatment group was immobilized with braces for 6 to 8 weeks and instructed for functional exercise, while the surgical treatment group received surgical treatment (longus tendon sheet graft transplantation, extensor tendon insertion reconstruction and direct extensor tendon suture were used respectively according to different injuries), and the patients were protected and fixed with plaster for 6 weeks and underwent functional exercise. The patients of two groups were followed up and compared in terms of wounded finger motion, under-extension angle, pain and complications. The treatment effects of the two groups were evaluated comprehensively by Dargan functional assessment method, and the factors affecting the treatment effect were analyzed by correlation analysis method.

  Results  The follow-up time was 5 to 8 months in the conservative treatment group, and 4 to 8 months in the surgical treatment group, with average of 6.3 months, and 6.8 months, respectively. The excellent and good rate of the conservative treatment group was 81.48%, and 87.04% in the surgical treatment group, but there was no significant difference in the excellent and good rate between the two groups (P>0.05). The time from injury to treatment was correlated with the curative effect in conservative treatment group (P < 0.05), while efficacy had no correlations with age and injuries fingers (P>0.05). There were no significant correlations of the time from injury to treatment, age, injuries fingers with efficacy in the surgical treatment group (P>0.05). The excellent and good rate of direct extensor tendon suture in the surgical treatment group was higher than the other two methods, but the difference was not statistically significant (P>0.05).

  Conclusion  For patients with tendinous mallet finger deformity, brace fixation is the priority for conservative treatment, but surgery is recommended for those with more than 3 weeks of injuries. The failure of conservative treatment does not affect the postoperative outcomes of surgical treatment.