[Non-surgical treatment of mallet finger fractures involving more than one third of the joint surface: 10 cases].

Operative stabilisation of mallet finger fractures is generally recommended in cases with more than one-third of the articular surface involved. Results of surgical stabilisation are often unsatisfying regarding anatomic reconstruction of the joint surface and mobility of the DIP joint. In a retrospective study we present the results of conservative treatment of 10 consecutive patients with mallet finger fractures involving one-third to two-thirds of the joint surface. Treatment consisted in splinting with a dorsal aluminium splint for 4 to 6 weeks, nightsplinting continued for a total of 8 weeks. Functional results at 9 months follow-up are very good with an extensor lag of maximally 5 degrees in 5 cases, a reduced flexion of maximally 10 degrees in 2 cases. All patients are pain-free. Radiological results show a very good remodelling of the DIP joint surface with anatomic joint congruency even in cases with initially up to 3 mm fragment displacement and 1 mm fragment rotation. There was no secondary palmar subluxation. Our findings support the conclusion of Wehbé and Schneider and Tuttle et al. that most mallet finger fractures can be treated conservatively, regardless the size and amount of displacement of the bone fragment. In conclusion, we consider that operative stabilisation has to be discussed only in the presence of palmar subluxation.