Treatment of Pediatric Bone Mallet Finger: The Current State of the Art and a Proposal of Algorithm Treatment

Abstract

Introduction: Bone Mallet finger is a common hand fracture and refers to a lesion of the terminal extensor complex with bone avulsion. In literature, so far, there is a lack of studies that identify the treatment for mallet finger in the pediatric population. For this reason, the purpose of this research is to clarify the correct treatment and to propose a therapeutic algorithm.

Materials and Methods: Thanks to the research database PubMed and Cochrane library we have selected all the studies regarding the mallet finger treatment in the pediatric population. Due to the shortage of specific studies, we have decided to include every result that satisfies our field of research.

Results: In literature there is no clear indication of the treatment of pediatric mallet finger. The treatment ranges from non-operative to surgical treatment.The conservative treatment is based on the immobilization of the distal interphalangeal joint for 6 weeks. By contrast, there are several surgical techniques that can be performed, including percutaneous fixation with K- wires (Ishiguro technique) and open reduction;

Discussion: We believe, that the different involvement of the articular surface of the distal interphalangeal joint plays a crucial role in the choice of treatment. According to the current studies, we have proposed an algorithm for treatment from x-ray assessment and classification system through conservative and operative intervention.