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)?
Sì = 1
Incerto = 0,5
Non rilevante = 0
No = 0
La valutazione dei criteri di segnalazione valuta la trasparenza con cui gli autori riportano le caratteristiche metodologiche e sperimentali dello studio all'interno della pubblicazione. La valutazione è suddivisa in cinque categorie che vengono presentate di seguito.
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
L'Indice di Fragilità è uno strumento che aiuta l'interpretazione dei risultati significativi, fornendo una misura della forza di un risultato. L'Indice di Fragilità rappresenta il numero di eventi consecutivi che devono essere aggiunti a un risultato dicotomico per rendere il risultato non più significativo. Un numero piccolo rappresenta un risultato più debole, mentre un numero grande rappresenta un risultato più forte.
Perché questo studio era necessario ora?
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.
Qual era la domanda di ricerca principale?
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).
Che cosa devo ricordare di più?
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.
Come influenzerà l'assistenza ai miei pazienti?
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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