fig : - extensor carpi radialis longus (ecrl), extensor carpi radialis brevis (ecrb), extensor carpi...
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![Page 1: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/1.jpg)
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![Page 2: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/2.jpg)
Fig : -
![Page 3: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/3.jpg)
Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC), Extensor digiti
minimi (EDM), Extensor indicis proprius (EIP), Abductor polliis longus (APL),
Extensor pollicis brevis (EPB) andExtensor pollicis longus (EPL).
• Fig :
![Page 4: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/4.jpg)
Fig :- showing the central slip and lateral bands
• Fig :
![Page 5: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/5.jpg)
Mallet Finger (baseball finger, drop finger , cricket finger )
.
Mallet finger of tendon originMallet finger of bony origin
Mallet finger : flexion deformity of terminal phalanx due to avulsion or rupture of extensor tendon
Mallet : hammer like
![Page 6: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/6.jpg)
Mallet Finger1
• Presentation– DIP Flexion +/- edema.
• Imaging– AP, lateral, oblique
![Page 7: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/7.jpg)
Mallet Finger1
![Page 8: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/8.jpg)
Mallet finger: Clinical presentation
![Page 9: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/9.jpg)
.• Fig : -
![Page 10: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/10.jpg)
![Page 11: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/11.jpg)
Mallet finger deformity due to a closed rupture of the extensor tendon with an associated avulsion fracture of the
terminal phalanx
![Page 12: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/12.jpg)
Tendon origin
• Due to loss of extensor tendon continuity at the distal finger joint
Mechanism of injury :
• The end of the finger is forcibly flexed , when extensor tendon is taut , e.g catching a ball , striking an object with extended finger
![Page 13: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/13.jpg)
Extensor tendon rupture
• Fig : -
![Page 14: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/14.jpg)
Fig :
• mallet deformity of the right middle finger along with the normal left finger shown for comparison.
![Page 15: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/15.jpg)
Cont..• Baseball finger (dropped finger, mallet
finger). Lateral view
![Page 16: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/16.jpg)
Four types of mallet finger injuries
• Type I: Closed with or without avulsion fracture• Type II: Laceration at or proximal to the DIP joint
with loss of tendon continuity• Type III: Deep abrasion with loss of skin,
subcutaneous cover and tendon substance• Type IV:• (A) Trans-epiphyseal plate fracture • (B) Hyperextension injury with fracture of the
articular surface and • (C) Hyperextension injury with fracture of the
articular surface and with early or late palmar subluxation of the distal phalanx.
![Page 17: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/17.jpg)
Fig :- mallet finger injury at the DIP joint
![Page 18: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/18.jpg)
Treatment
For type I injuries : -• continuous splinting of the DIP joint in extension
for six weeks, followed by two weeks of night splinting.
- K – wire fixation of the DIP joint in extension, for six weeks followed by two weeks of night splinting.
![Page 19: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/19.jpg)
Fig :showing the use of a splint in treating closed mallet injury
![Page 20: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/20.jpg)
Type II
• injuries may be repaired with a simple figure-of-eight suture through the tendon alone.
• DIP joint is splinted in extension for 6 weeks, followed by 2 weeks of night splinting.
![Page 21: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/21.jpg)
Cont..
Type III injuries with loss of tendon substance require :
• immediate soft tissue coverage and primary grafting or late reconstruction using a free tendon graft.
![Page 22: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/22.jpg)
Cont.. Type IV-A : - • closed reduction followed by splinting for 3-4
weeks. Type IV-B with no palmar subluxation:- • good results with 6 weeks splinting and 2 weeks
night splinting. Type IV-C with palmar subluxation of the distal
phalanx : - • open reduction and internal fixation using K -
wire. splint for 6 weeks, after which the wire is removed and motion started.
![Page 23: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/23.jpg)
Fig : - external fixator in position.
• .
![Page 24: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/24.jpg)
Posture When relaxed, the hand lies in a characteristic posture with the thumb-tip held
slightly flexed and fingers held in a cascade. Any change in the resting posture can suggest tendon
or even nerve damage • Fig : -
![Page 25: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/25.jpg)
Fig : - Examination of the extensor tendons showing normal function of the extensor communis (left) and extensor proprius (right) tendons
![Page 26: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/26.jpg)
Flexion of the fingers demonstrates loss of active movement at the tip of the ring finger
(due to a closed flexor tendon (FDP) rupture)
![Page 27: Fig : - Extensor carpi radialis longus (ECRL), Extensor carpi radialis brevis (ECRB), Extensor carpi ulnaris (ECU), Extensor digitorum communis (EDC),](https://reader033.vdocuments.net/reader033/viewer/2022061415/56649eda5503460f94be9456/html5/thumbnails/27.jpg)
Mallet Finger Thumb Splint