Feasibility work to inform a main RCT in mallet injury

Soft tissue and bony mallet injuries are extremely common. Fracture or tendon disruption leads to loss of extension of the distal interphalangeal joint, pain and sometimes permanent disability.

The majority of mallet injuries are treated with splints. There is no consensus as to the optimum duration of splintage which ranges between 4 and 12 weeks.

Recent evidence has shown uncertainty about the incidence of injuries, current practice and treatment policies (2004; 2015). This calls for well designed and conducted trials in Mallet injury.

We have been funded by the British Society for Surgery of the Hand (BSSH), the University of Bristol, and the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) to undertake feasibility work to inform the design of a trial in Mallet injury.

This work will establish how to assess patient adherence with splints and outcome assessment. We will establish outcomes of importance to patients, surgeons and hand therapists.

A survey of surgeons and hand therapists to gauge expert opinion is imminent. We are investigating the literature to understand methods for the assessment of adherence to joint or limb immobilisation and to summarise outcome measures. We will interview with patients and staff to explore which outcomes are most relevant.

This work is led by an expert multi-disciplinary team.

For more information please contact Shelley Potter.