Effect of continued nightly splinting on extensor lag in patients with mallet finger .
This report has been verified
by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2014;2(15):10 Hand (N Y). 2014 Jun;9(2):145-5059 patients (>18 years of age) who were diagnosed with mallet finger (with or without fracture) and who had undergone continuous splint/cast immobilization and hyper-extension intervention (6-8 weeks), were randomly assigned into 1 of 2 treatment groups to determine the effect of an additional one month of night splinting on extensor lag. Participants either received an additional one month intervention with a night splint following their continuous splinting period or received no additional intervention (control). Results from the study demonstrated that no significant differences existed between the two groups by final follow-up when comparing the final extensor lag, disability, or treatment satisfaction experienced by patients.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Ja = 1
Ungewiss = 0.5
Nicht relevant = 0
Nein = 0
Die Bewertung der Berichtskriterien bewertet die Transparenz, mit der die Autoren die methodischen und studienspezifischen Merkmale der Studie in der Veröffentlichung angeben. Die Bewertung ist in fünf Kategorien unterteilt, die im Folgenden vorgestellt werden.
3/4
Randomization
2/4
Outcome Measurements
2/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
Der Fragilitätsindex ist ein Instrument, das bei der Interpretation signifikanter Ergebnisse hilft und ein Maß für die Stärke eines Ergebnisses liefert. Der Fragilitätsindex gibt die Anzahl der aufeinanderfolgenden Ereignisse an, die zu einem dichotomen Ergebnis hinzugefügt werden müssen, damit das Ergebnis nicht mehr signifikant ist. Eine kleine Zahl steht für ein schwächeres Ergebnis und eine große Zahl für ein stärkeres Ergebnis.
Warum wurde diese Studie jetzt benötigt?
Following the occurrence of mallet finger, a variety of adverse events can occur, with the most prominent event being extensor lag. The effect night splinting has on this adverse event following a continuous splinting period (6 to 8 weeks) is currently unknown, and so, the goal of this study was to determine if there is any positive correlation between the two.
Was war die wichtigste Forschungsfrage?
After 6-8 weeks of continuous splint or cast immobilization for mallet finger, is there a difference in residual extensor lag between those who continued intervention with nightly splinting for 1 month versus those who did continue with nightly splinting?
- Average extensor lag experienced by patients within the study was 14 degrees (range 0 to 42). 6 patients in the night splint group and 8 in the control group had final extensor lag of 20 degrees or greater. The difference between groups regarding this outcome was not significantly different (p>0.05).
- Final extensor lag significantly correlated with age (p=0.006), final FIP flexion (p=0.005), enrollment extensor lag (p=0.001), and enrollment DIP flexion (p=0.014).
- Enrollment lag and follow-up DIP flexion accounted for 28% of the variation in final extensor lag (p<0.001).
- Mean DASH score and satisfaction levels were comparable between the two groups at final follow up (p=0.67 and 0.48, respectively). Mean DASH among participants in the study was 8.8 (range 0 to 54) by final follow up and, 8.2 with regard to satisfaction score (range 0 to 10).
Was sollte ich mir besonders merken?
No significant differences existed between the two groups by final follow up when comparing final extensor lag, disability, or treatment satisfaction. Significant correlations between extensor lag and age, enrollment distal interphalangeal joint (DIP) flexion and extensor lag, and final DIP flexion was observed.
Wie wird sich dies auf die Behandlung meiner Patienten auswirken?
The results of this study suggest that supplemental night splitting does not improve the outcome of mallet finger with regard to extensor lag, disability, or treatment satisfaction. Patient preference should be considered in decision-making processes. Further research with a larger sample size and longer follow up period is warranted.
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