Physiotherapy for Mallet Finger with Rehab Management


Bismillahirahmanirahim

What u should know:
1) What is mallet finger?
2) How to fabricate mallet splint?
3) Protocol of mallet finger

What is mallet finger
·         Mallet finger refers to a condition in which the end joint of a finger bends but will not straighten by itself.  In this situation, the joint can be pushed straight but will not hold that position on its own. 
·         It is condition, where there is an interruption of the extensor tendon mechanism at the DIPJ


Causes:
1.      The mechanism which straightens the end joint has been disrupted. This usually happens when the tip of the finger is pushed down while the person is trying to straighten their finger

2.      The tendon which pulls on the end bone to straighten the finger pulls one way, and the force on the end of the fingertip pulls the other way, and something comes apart in between. Often, the tendon tears away from its attachment to the bone:

3.      Sometimes, the tendon comes off with a piece of bone attached,    In worse cases, the tendon comes off with a fairly large piece of bone, which can make the rest of the joint slide out of alignment. Fortunately, that is not very common


Rehab Management
·         Patient education
·         Consent
·         Splinting
·         ROM exercise

Protocol of mallet splint
·         Continual wear of splint for 4-6 weeks
·         For chronic injury allow splint for 8 weeks.
·         No active or passive flexion for DIPJ
·         Allow and maintain movement for PIPJ and MCPJ.
·         Restart counting the splinting weeks, if the splint suddenly slip out from the DIPJ.

4-6 weeks:
·         Check for extensor lag after 4 weeks, and discontinue wear if no extensor lag
·         Continue wear if there is extensor lag for another 2 weeks.
·         Allow for ROM exs, but need to be worn during night.

6-8 weeks:
·         Blocking exs for DIPJ gently and gradually.
·         Splint need to be worn at nite
·         IF there is extensor lag after ROM exs daytime, continue wearing splint daytime and remove for exercise only.

Wallahuaklam..




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