A randomized controlled trial of the effect of 2-step orthosis treatment for a mallet finger of tendinous origin

• Published in: Journal of hand therapy Vol. 29; no. 4; pp. 433 - 439
• Main Authors: Saito, Kazuo, PhD, OTR, Kihara, Hitoshi, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2016; Elsevier Limited
• Subjects: 2-step orthosis; Adult; Aluminum; Braces; Clinical trials; Equipment Design; Female; Finger Injuries - diagnosis; Finger Injuries - rehabilitation; Hand therapy; Humans; Injury Severity Score; Knee; Male; Mallet finger of tendinous origin; Middle Aged; Pain; Patients; Physical Medicine and Rehabilitation; Prospective Studies; Randomized controlled trial; Range of Motion, Articular - physiology; Risk Factors; Standard deviation; Tendon Injuries - diagnosis; Tendon Injuries - rehabilitation; Treatment Outcome; 2-step orthosis; Hand therapy; Randomized controlled trial; Mallet finger of tendinous origin
• ISSN: 0894-1130; 1545-004X
• DOI: 10.1016/j.jht.2016.07.005

Abstract Study Design A randomized clinical trial, with patients treated either by new 2-step orthosis or by the figure–eight-type orthosis with the distal interphalangeal (DIP) joint extended. Purpose of the Study To report on our new orthosis and to evaluate the treatment efficacy of using a 2-step orthosis for the treatment of a mallet finger of tendinous origin compared with a conventional orthosis. Methods Forty-four patients were randomized into the 2-step or conventional orthosis groups. Primary outcomes were active DIP joint flexion and extensor lag, pain, and the Abouna–Brown criteria. Results The 2-step orthosis was associated with a smaller active DIP extensor lag, compared with the conventional orthosis (−7.5 ± 4.5° vs −16.4 ± 6.9°, P  = .001), combined with a significantly higher Abouna–Brown criteria ( χ2  = 14.57, P  = .01). No other between-group differences were identified. Conclusion The therapeutic effectiveness of the 2-step orthosis, over a conventional orthosis, was supported by a large effect size of the treatment in improving residual active extensor lag at the DIP and overall Abouna–Brown criteria. Our study thus suggested that the initial immobilization involved in new 2-step orthosis and is thus a good immobilization technique. Level of Evidence Ib.