Distal Interphalangeal Joint Dislocations

Report By: Faheem Shah - Speciality Doctor A&E
Search checked by Helen Goldrick - Consultant in Emergency medicine
Institution: Royal Albert Edward Infirmary, WWL NHS Trust, WIgan.
Date Submitted: 20th December 2005
Last Modified: 16th April 2010
Status: Blue (submitted but not checked)

Three Part Question

In [patient with DIP joint dislocations]Is [splinting better than non splinting & early mobilisation]for [Return to normal function]?

Clinical Scenario

A 24 year old healthy man presented to minors department with deformity to his right hand middle finger, as it was hit by cricket ball in the cricket match. Right hand middle finger distal interphalngeal joint was dislocated, confirmed on xrays, reduced successfully using entonox & position confirmed on check xray. When the patient was about to be discharged home, you wonder whether to put neighbour strapping or leave it without neighbour strapping for the patient to mobilise his finger, so to return to his daily life activities straight away.

Search Strategy

Medline via Health Information resources NHS Evidence interface (Formerly National library of Health)1950 – Nov 1st 2010
(distal AND interphalangeal AND joint).ti,ab AND exp DISLOCATIONS/ OR exp FINGER INJURIES/
AND
exp SPLINTS/OR(neighbour AND strapping).ti,ab OR (mallet AND splint$).ti,ab limit to (english language and humans and (controlled clinical
trial or meta analysis or randomized controlled trial or "review"))

Search Outcome

118 articles were found , out of which none were relevant to the question.

Comment(s)

There is no evidence for using neighbour strapping or mallet splint after reducing the dislocation of distal interphalangeal joints, if there is no tendon injury or mallet finger.

Clinical Bottom Line

There was no evidence found to show there is any benefit from splinting after the dislocation of distal interphalageal joint is reduced. Local advice should be followed.