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)?
Sí = 1
Incierto = 0,5
No relevante = 0
No = 0
La evaluación de los criterios de información evalúa la transparencia con la que los autores informan de las características metodológicas y del ensayo dentro de la publicación. La evaluación se divide en cinco categorías que se presentan a continuación.
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
El Índice de Fragilidad es una herramienta que ayuda en la interpretación de hallazgos significativos, proporcionando una medida de fuerza para un resultado. El Índice de Fragilidad representa el número de eventos consecutivos que es necesario añadir a un resultado dicotómico para que el hallazgo deje de ser significativo. Un número pequeño representa un hallazgo más débil y un número grande un hallazgo más fuerte.
¿Por qué se necesitaba ahora este estudio?
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.
¿Cuál era la pregunta principal de la investigación?
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).
¿Qué es lo que más debo recordar?
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.
¿Cómo afectará esto al cuidado de mis pacientes?
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.
DESCARGO DE RESPONSABILIDAD
El contenido de esta página tiene únicamente fines informativos y no pretende sustituir el consejo, diagnóstico o tratamiento médico profesional. Si necesita tratamiento médico, busque siempre el consejo de su médico o acuda al servicio de urgencias más cercano. Las opiniones, creencias y puntos de vista expresados por las personas sobre el contenido que se encuentra en esta página no reflejan las opiniones, creencias y puntos de vista de OrthoEvidence.
0 de 4 artículos mensuales GRATIS desbloqueados
