Systematic Review & Meta-Analysis of Conservative versus Surgical Treatment in Management of Closed Mallet Finger

Abstract

Background: Several methods of treatment have been mentioned in management of closed mallet finger injury, as conservative methods using stack splint,dorsal aluminum splint or custom thermoplastic splint, or surgical procedures as direct pinning method, extention block technique or hook plate fixation. Objectives: The aim of the study is to systematically review & meta-analyze the outcomes of conservative versus surgical treatment in management of closed mallet finger injury and statistically compare between their results of pain, extensor lag, range of motion of distal inter-phalangeal joint. Materials and Methods: The review will be restricted to RCTs, clinical trials, and comparative studies, either prospective or retrospective, which studied the outcome of conservative versus surgical treatment in management of closed mallet finger, articles published in English. Results: About 950 articles were found using search keywords. By filtration and screening of the title and exclusion of unrelated articles, about 150 articles were found. By applications of all inclusion and exclusion criteria, only 55 articles which met all inclusion criteria, 50 studies were systematically reviewed, and 5 randomized controlled trials were fit to undergo a meta-analysis. Conclusion: In conclusion, there were no significant differences among the conservative and the surgical groups regarding the pain score (VAS), distal inter-phalangeal joint extensor lag (degree), and distal interphalangeal joint range of motion (degree) in treatment of closed mallet finger. Keywords: Mallet finger, DIP joint, extensor tendon avulsion.