Introduction
While mallet finger is a relatively common hand injury, mallet thumb is a much rarer occurrence, accounting for only 2-3% of all mallet injuries.1 Literature assessing the management and subsequent outcomes of mallet thumb is limited, and little consensus exists as to the optimal treatment of this condition. Both conservative and surgical approaches have been utilised, with a range of techniques within each approach. When managed conservatively, both immobilisation of just the IPJ, as well as hand based splints are employed. Similarly, a range of surgical techniques have been described.1-2
Method
This is a review of the management and outcomes of all non-bony mallet thumbs treated at Waitaha Canterbury over 5 years (January 2019 - December 2024). Patient demographics, mechanism of injury, management technique, complications and functional outcomes were reviewed.
Results
Provisionally 5 cases have been identified (final results to be confirmed), with 2 cases managed operatively and 3 non-operatively. All patients treated non-operatively were managed in a mallet splint with immobilisation of the IPJ only. Both patients treated operatively were managed with a suture repair to remnant tendon distally, at a range of 1-7 days post injury. Range of movement outcomes were similar between all patients, with intact extensor mechanisms
Conclusion
Mallet thumb is a rare clinical entity with little consensus as to the best management approach. This study suggests that non operative management is effective and immobilisation of the IPJ alone is sufficient.
References
1. Hirslund E, Patience C, Hang P et al. Comparative Outcomes Between Surgical and Conservative Management of Mallet Thumb: A Systematic Review and Pooled Analysis. HAND. 2024;0(0).
2. Kastenberger T, Kaiser P, Benedikt S et al. Surgical treatment of the bony mallet thumb: a case series and literature review. Arch Orthop Trauma Surg. 2022 May;142(5):887-900.