Surgical Procedure, Tenodermodesis, Appears Safe and Effective Treatment for Severe Soft-Tissue Mallet Finger Deformities in Children

Children frequently have fingertip injuries and the most common one is called the mallet finger. Because the initial trauma may not be severe and the injury doesn't appear to hinder movement or function, the injury frequently is not diagnosed in the early stages. By the time the injury is brought to a physician's attention, a considerable period of time may have passed. As well, when the injury is treated early, the treatment is often too difficult for full compliance (full finger extension, full time), and the results may not be optimal.

Casting or full-time extension is the usual course of action when a patient presents with established mallet finger deformities, however, the authors of this study wanted to review the results of tenodermodesis, surgery to straighten the finger, to assess its effectiveness.

The records of 10 children, average age 7.4 years, who had undergone the procedure were reviewed and the patients were followed for an average of 6.5 years. The surgery had been performed because of functional and aesthetic reasons.

After an average of 6.5 years, all patients had some restored function to the finger; two patients obtained full extensor function, eight patients had a lag of 20 degrees or less, down from 40 degrees before the surgery. Two of the patients were left with mild nail plate deformities. Eight of the 10 patients found now significant limitation in function for their regular activities, although one patient did complain of mild pain and another temperature intolerance of the affected finger.

The authors conclude that, despite the small size of the study group, tenodermodesis is a viable option for treatment for chronic mallet fingers in children.