Surgical repair of mallet finger injury is indicated in any of these situations12,14:
injury is caused by laceration
there is volar subluxation of the DIP joint
more than one-third of the articular surface is involved in an avulsion fracture.
Patients who cannot comply with wearing a splint 24 hours per day or whose occupation precludes wearing a splint at all (eg, surgeons, dentists, musicians) are also surgical candidates.12
Surgical and conservative treatments have similar clinical and functional outcomes, including loss of approximately 5° to 7° of active extension and an increased risk of DIP joint osteoarthritis.12,14,24 Patients with chronic mallet finger can be managed with 6 weeks of splinting initially but will likely require surgery.6,12,13
Skier’s thumb
This relatively common injury is a tear of the ulnar collateral ligament (UCL) at the MCP joint of the thumb.16
Causes and incidence.Skier’s thumb occurs when a valgus force hyperabducts the thumb,16 and is so named because the injury is often seen in recreational skiers who fall while holding a ski pole.15-17 It can also occur in racquet sports when a ball or racquet strikes the ulnar side of thumb.16
