From the Guidelines
For finger extensor tendon subluxation, a custom-made thermoplastic splint that immobilizes the metacarpophalangeal (MCP) joint in 15-30 degrees of flexion while allowing the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints to move freely is recommended. This type of splint is often called a sagittal band splint or MCP blocking splint. The provided evidence does not directly address the question, as it discusses the treatment of acute Achilles tendon rupture 1. However, based on general medical knowledge, the recommended splint should be worn continuously for 4-6 weeks to allow the sagittal bands to heal in proper position. After this initial period, the splint can be worn only during activities for an additional 2-4 weeks. The splint works by preventing the MCP joint from fully extending, which keeps the extensor tendon centered over the metacarpal head and prevents it from slipping into the valley between the metacarpal heads. Some key points to consider when using this type of splint include:
- The splint should be comfortable enough to maintain compliance but firm enough to prevent full MCP extension
- Early splinting is crucial for conservative management success, as chronic subluxation may eventually require surgical repair
- The splint allows for mobilization of the PIP and DIP joints, which helps to prevent stiffness and promote healing.
From the Research
Finger Extensor Tendon Subluxation Treatment
The type of splint used for finger extensor tendon subluxation is not explicitly stated in the provided studies. However, the following information can be gathered:
- For extensor tendon injuries, a dynamic splinting program with an outrigger splint holding the fingers in extension and allowing full active flexion can be used 2.
- For mallet finger, a prefabricated splint holding the DIP-joint in extension or a temporary arthrodesis with a Kirschner-wire blocking the DIP-joint in extended position can be used 3.
- For Boutonnière deformity, a conservative treatment with a splint holding the PIP-joint in extension may be successful 3.
- A low-profile relative motion splint can be used for zone VI extensor tendon injuries, allowing for early protected motion 4.
- A dynamic outrigger splint or a palmar blocking splint can be used for complete divisions of extensor tendons in zones 5 and 6 5.
- For metacarpophalangeal (MCP) extensor tendon subluxation caused by finger flicking injury, a direct repair of the sagittal band can be performed, and a splint is not specifically mentioned 6.