Conservative management equally effective to new suture anchor technique for acute mallet finger deformity: A prospective randomized clinical trial


Batibay S. G., Akgul T., Bayram S., Ayik Ö., Durmaz H.

JOURNAL OF HAND THERAPY, sa.4, ss.429-436, 2018 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2018
  • Doi Numarası: 10.1016/j.jht.2017.07.006
  • Dergi Adı: JOURNAL OF HAND THERAPY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.429-436
  • Anahtar Kelimeler: Bone mallet injury, Anchor suture, Orthotic device, DIP joint, Mallet finger, INTERPHALANGEAL JOINT SUBLUXATION, INJURIES, SPLINT, HAND
  • İstanbul Üniversitesi Adresli: Evet

Özet

Study Design: Prospective randomized controlled trial. Purpose of the Study: This study was designed to compare our new suture anchor technique with conservative management in acute Wehbe-Schneider type I A-B and II A-B mallet fingers. Methods: Twenty nine patients who presented to our clinic between 2013 and 2015 were randomized for surgical or conservative treatment. Wehbe-Schneider subtype C fractures were excluded. Fourteen were treated with surgery, and 15 were treated with conservative treatment. Primary outcomes were visual analog scale score, active distal interphalangeal (DIP) joint flexion, return to work, extension deficit and DIP joint degeneration. Follow-up time was 12 months. Results: The mean visual analog scale was 2.0, and return to work was on average in 63.2 days in the surgical group and 1.47 and 53.7 days in the conservative group. Extension deficit was 8.1 degrees in the surgical group and 6.1 degrees in the conservative group. The mean DIP flexion at final follow-up was 54.5 degrees (40-65) in the surgery group and 58.3 degrees (45-70) in the conservative group. DIP joint degeneration was observed with X-rays in 4 patients in surgical group, and none of the patients in the conservative group had DIP degeneration at 1 year after treatment. Conclusions: The therapeutic effectiveness of suture anchor technique was not statistically different from conservative treatment. Subluxation seen after fixation treatment with suture anchors may be due to inadequate anchor fixation. DIP joint degeneration was seen significantly more in the surgical group. Our study suggests that the new suture anchor technique is not superior to conservative treatment. (C) 2017 Hanley & Belfus, an imprint of Elsevier Inc. All rights reserved.