Mallet fracture therapy

A combination Tip Protector/Mallet splint is applied to the DIP joint for continual wear.

Active and Passive Range of Motion exercises are initiated to the MCP and PIP joints 15 min/hr.

6 weeks:

The DIP pin is removed, if present.

The Mallet splint is continued at night. No range of motion exercises are initiated at this point. Ordinarily, nighttime splinting is continued for six weeks following initial mobilization.

7 weeks:

The patient is checked for the presence of an extension lag. If there is any extensor lag at this point, continuous mallet splinting is restarted for two weeks. The patient is at that point reevaluated for a lag.

If no extensor lag is present, then the patient is started on active range of motion and blocked active flexion exercises four time daily.

8 weeks:

Passive Range of Motion exercises are initiated to the DIP joint 15 min/hr.

Ordinarily nighttime splinting is continue for six weeks following initial mobilization.

Twelve weeks (or six weeks following discontinuation of daytime splinting), dynamic flexion splinting is initiated as needed.

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