tREAtmENt Of mALLEt fINGER – A REvIEw

Disruption of the finger’s extensor apparatus at its terminal portion, causing inability to extend distal interphalangeal joint (abbreviation: DIP) and dropping of the distal phalanx, results with well known „mallet finger” deformity. This deformity can be caused by simple rupture of extensor apparatus, or avulsion fracture of the dorsal rim of the articular surface of distal phalanx. Sudden, forceful flexion of extended distal phalanx can easily damage thin terminal tendon inserted on the distal phalanx. The cause can be either direct blow to the distal phalanx, sharp or blunt injury to the distal interphalangeal joint (1). Swelling, tenderness and redness over the dorsal aspect of the DIP joint can accompany dropping and lack of active extension. Such inflammatory-like symptoms can develop in case of prolonged untreated injury. Lack of active extension can be either distinct or discrete (from few to several dozen degrees) respectively to complete or incomplete disruption of extensor apparatus or due to locking of avulsed fragment of the distal phalanx amid soft tissues. Several classifications of this pathology can be found in the literature, including Doyle classification and Whebe-Schneider classification (2, 3). The former, new, more versatile, includes all possible patterns of injuries resulting with mallet finger deformity (tab. 1). The latter concerns bony mallet finger deformities (tab. 2). Another one, a Crawford classification, is used to classify outcomes of treatment (tab. 3) (4).