Gurnani Navin, Hoogendoorn Jochem, Rhemrev Steven
Medisch Centrum Haaglanden, afd. Orthopedie, Den Haag.
Ned Tijdschr Geneeskd. 2014;158:A6941.
Mallet finger is a very common injury, but there is still much discussion about the best treatment. Mallet finger should be operated on if a fracture is larger than 1/3 of the articular surface or in volar subluxation, because otherwise the fracture may remain unstable or there may be loss of function. However, we believe that most mallet fingers can be treated conservatively. Consideration of the relevant literature from PubMed shows that nearly all cases of mallet finger can be treated conservatively with a splint, without significant differences in function, deformity or pain versus surgical treatment. Although there is no significant difference in complications between splinting and surgery, the complications of an operation may be far more serious. In spite of the current operation indication, we should be more reluctant to operate on mallet finger.
锤状指是一种非常常见的损伤，但关于最佳治疗方法仍有很多讨论。如果骨折大于关节面的1/3或存在掌侧半脱位，则应进行手术治疗锤状指，因为否则骨折可能仍不稳定或可能出现功能丧失。然而，我们认为大多数锤状指可以保守治疗。查阅PubMed上的相关文献表明，几乎所有锤状指病例都可以用夹板保守治疗，在功能、畸形或疼痛方面与手术治疗相比没有显著差异。虽然夹板固定和手术在并发症方面没有显著差异，但手术的并发症可能要严重得多。尽管有目前的手术指征，但我们对锤状指手术应更加谨慎。
