Department of Orthopedics and Traumatology, Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences Turkey, Ankara, Turkey.
Department of Plastic, Reconstructive, and Aesthetic Surgery, Baskent University, Adana, Turkey.
J Hand Surg Asian Pac Vol. 2021 Mar;26(1):47-51. doi: 10.1142/S2424835521500077.
Stack splint is commonly used for mallet finger treatment but patients had a tendency to frequently remove it because of skin complications. We hypothesized that a comprehensively instructed splinting regime would increase patients' compliance and lead to favorable outcomes with fewer skin complications. The aims of this study were to assess the patients' compliance and to evaluate outcomes with that particular splinting regime. Forty-six consecutive patients were enrolled in this prospective study. They were instructed to wear the Stack splint for 24 hours a day every day in the first six weeks and remove it once a day for 10 minutes to vent. They were told to support distal interphalangeal joint volarly both while wearing the splint and when it was removed. Free movement of proximal interphalangeal joint within the splint was checked after each application. Following whole-day regime for 6 weeks, night splinting continued for 2 more weeks. Range of motion, skin complications, patients' compliance and satisfaction were assessed at last follow-up. There were 26 patients with a mean age of 39.8 and mean follow-up period of 6.7 months. No skin complications or proximal interphalangeal joint stiffness were reported. However, nine patients declared that they wore the splint ≤ 4 weeks, the compliance rate to our regime was 65.4% (17/26). In the 17 fully compliant patients, mean distal interphalangeal joint extension lag was 12.4 and nine of them (52.9%) were satisfied with the outcome. Our both hypotheses failed; comprehensive instructions for the splinting regime did not improve patients' compliance satisfactorily, nor did it lead to favorable outcomes. Although Stack splint has practical points, we no longer use it.
掌指骨固定夹板通常用于槌状指治疗，但由于皮肤并发症，患者往往会频繁取下夹板。我们假设一个全面指导的固定方案将增加患者的依从性，并减少皮肤并发症，从而获得更好的结果。本研究的目的是评估患者的依从性，并评估该特定固定方案的结果。
46 例连续患者纳入本前瞻性研究。他们被指示在最初的 6 周内每天 24 小时佩戴 Stack 夹板，每天取下夹板 10 分钟通风。告知他们在佩戴夹板和取下夹板时都要向远节指间关节掌侧支撑。每次应用后检查近节指间关节在夹板内的自由活动度。6 周全天佩戴后，夜间固定再持续 2 周。在最后一次随访时评估关节活动度、皮肤并发症、患者依从性和满意度。
26 例患者的平均年龄为 39.8 岁，平均随访时间为 6.7 个月。无皮肤并发症或近节指间关节僵硬。然而，9 名患者表示他们佩戴夹板的时间≤4 周，依从率为 65.4%（26 例中有 17 例）。在 17 名完全依从的患者中，远节指间关节伸展滞后的平均为 12.4，其中 9 名（52.9%）对结果满意。
我们的两个假设都失败了；全面的固定方案指导并没有使患者的依从性得到令人满意的提高，也没有带来良好的结果。尽管 Stack 夹板有实际的优点，但我们不再使用它。
