PREFERRED PRACTICE PATTERN
4E: Impaired joint mobility, motor function, muscle performance, and ROM associated with localized inflammation1
The patient is a 46-year-old man who injured his middle finger while playing a casual game of basketball with friends. He reports that he attempted to catch a rebound, and the ball struck his outstretched finger, forcibly bending it. Examination revealed a characteristically flexed distal interphalangeal (DIP) joint and patient’s inability to actively extend the DIP joint; X-ray revealed no bony disruption; mild swelling was present.
Distal joint of the finger is bent into a claw-like position
Usually due to trauma from impact on tip of the finger2
Flexor muscles, fascia, tendons shorten
Disruption of the extensor tendon, 15 to 20 degree loss of DIP finger extension
Flexion of the DIP joint
Diagnosis is usually made by clinical examination or x-ray
Finger extension strength, often extensor digitorum communis injury
Mallet splint. The finger is splinted with distal interphalangeal joint held in extension. (From Patel DR, Greydanus DE, Baker RJ. Pediatric Practice: Sports Medicine. www.accesspediatrics.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
Pain with grasping, holding objects
Inability to extend the finger
At risk of injury in factories as finger not in alignment with the others and can get caught or injured
Possible Contributing Causes
Mechanism of mallet finger injury. (From Patel DR, Greydanus DE, Baker RJ. Pediatric Practice: Sports Medicine. www.accesspediatrics.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)
FINDINGS AND INTERPRETATION
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