The conservative treatment of mallet finger with a simple splint: a case report. Mallet finger: a trial of two splints. A comparative controlled trial of a new perforated splint and a traditional splint in the treatment of mallet finger. Randomized controlled trial of nocturnal splinting for active workers with symptoms of carpal tunnel syndrome.
Sixty patients with mallet finger deformity were randomly treated with either a Stack or a custom-made padded aluminium alloy malleable finger splint. Both splints were equally effective in correcting the deformity but the aluminium alloy splint was able to be fitted to a wider variety of finger shapes and sizes and caused significantly fewer skin complications. Over a period of twelve months, 116 cases of mallet finger were allocated randomly to treatment with either a Stack or Abouna splint. The two splints were equally effective, producing a cure or a significant improvement in approximately 50% of cases. However, the Stack splint was much preferred by the patients, who found it more comfortable, more robust and easier to keep clean. A perforated mallet finger splint is described and the results of a controlled trial comparing its use with a conventional splint are presented. The perforated splint gives superior results by virtue of the fact that it does not require to be removed for purposes of hygiene and can thus produce a satisfactory result even in those patients who fail to grasp the technique of removal and replacement of the splint. To determine whether nocturnal splinting of workers identified through active surveillance with symptoms consistent with carpal tunnel syndrome (CTS) would improve symptoms and median nerve function as well as impact medical care.
                Randomized controlled trial.
                A Midwestern auto assembly plant.
                Active workers with symptoms suggestive of CTS based on a hand diagram.
                The treatment group received customized wrist splints, which were worn at night for 6 weeks; the control group received ergonomic education alone.
                Change in wrist, hand, and/or finger discomfort, carpal tunnel symptom severity index, median sensory nerve function, and the percentage of subjects who had carpal tunnel release surgery.
                The splinted group, unlike the controls, had a significant reduction in wrist, hand, and/or finger discomfort and a similar trend in the Levine carpal tunnel symptom severity index, which was maintained at 12 months. A secondary analysis showed that more median nerve impairment at baseline was associated with less clinical improvement among controls but not among the splinted group.
                Workers identified with CTS symptoms in an active symptom surveillance tended to benefit from a 6-week nocturnal splinting trial, and the benefits were still evident at the 1-year follow-up. The splinted group improved in terms of hand discomfort regardless of the degree of median nerve impairment, whereas the controls showed improvement only among subjects with normal median nerve function. Results suggest that a short course of nocturnal splinting may reduce wrist, hand, and/or finger discomfort among active workers with symptoms consistent with CTS.
There was insufficient evidence from comparisons tested within randomised controlled trials to establish the relative effectiveness of different, either custom-made or off-the-shelf, finger splints used for treating mallet finger injury. There was a useful reminder that splints used for prolonged immobilisation should be robust enough for everyday use, and of the central importance of patient adherence to instructions for splint use. There was insufficient evidence to determine when surgery is indicated.