Study design Randomized clinical trial. Introduction Although orthotic immobilization has become the preferable treatment choice for closed mallet injuries, it is unclear whether orthosis self-removal has an impact on the final outcome. Purpose To evaluate the treatment efficacy of cast immobilization of closed mallet fingers using Quickcast® (QC) compared to a removable, lever-type thermoplastic orthosis (LTTP). Methods 57 subjects were randomized in 2 groups. DIPj extensor lag and the Gaberman success scale were used as primary outcomes. Results LTTP subjects resulted in greater extensor lag than QC subjects (x = 5°; p = 0.05) at 12 weeks from baseline, and high edema and older age negatively affected DIPj extensor lag. No other differences were found between groups. Conclusion Cast immobilization seems to be slightly more effective than the traditional approach probably for its greater capacity to reduce edema. Level of evidence 1B.
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