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3 reasons why stack splints are not ideal for mallet injuries

Stack splints are pre-fabricated off the shelf splints designed for mallet finger injuries. They are used as a way to support the finger and hold the finger tip straight. Used initially for a couple of days they are ok, but for anything longer, they are not ideal. Here is why.

A mallet injury occurs to the fingertip, where it droops forward and is unable to be straightened. This can be due to either a fracture (boney mallet) or a tendon rupture (tendinous mallet) injury. Both types of mallet injury mean there is no connection of the muscle to the phalanx to extend or lift the fingertip. For more information about mallet finger injuries refer to our blog: Why is my finger tip drooping?

Mallet injuries need to rest in a splint full time for a minimum of 6 weeks, and sometimes up to 10 weeks depending on the type of injury and severity. It is therefore important to have the correct type of splint to achieve the best outcomes and allow your finger to be comfortable.

Stack splints come is a selection of sizes and are often given out by hospitals, GP clinics or health care professionals who do not specialise in hand therapy. A “stack” splint refers to its shape design, and is a type of splint that is pre-made and sold for mallet finger injuries.

Why we don’t rave about stack splints.....

1. Stack splints are often ill-fitting As stack splints are pre-made and pre-purchased, they are not custom fit to the individual’s finger, therefore not everyone’s finger comfortably fits into the splint. This also means when they are first administered by a doctor or health care professional, they will be fitted to you when your finger is most swollen. To achieve good outcomes for your mallet injury a splint should be custom made to fit your finger and cope with a change in size or swelling.

2. Stack splints cover the finger tip The stack splint design supports the finger from the volar or palmer side, consequently covering the fingertip. We find that this hinders your ability to perform functional tasks, as you do not receive the sensory feedback when touching or picking up objects. It also makes fine motor tasks such as doing up buttoned shirts, picking up coins or tying shoes laces, very difficult. The custom fit thermoplastic splints made at Health Nest support the mallet injury from the dorsal or top of the finger, which frees the fingertip.

3. Stack splints do not correctly support the finger Stack splints are designed to support the fingertip joint, also known as the DIP joint, in a straight position. This is not the best practice if you have a tendinous mallet finger injury. Tendinous mallet injuries should be splinted in slight hyperextension to promote tendon healing and no lengthening of the tendon. Although stack splints are designed to hold the finger in neutral, if they are fitted to a swollen finger, when the swelling reduces the finger will re-assume a slightly drooped position. This will result in poor healing and a “lag” (refer to the blog: Why is my finger tip drooping?). Custom made splints at Health Nest are moulded to position your finger correctly, they are checked regularly and remoulded when needed.

It is important to splint your mallet correctly and as soon as possible. Stack splints are beneficial in the interim if you cannot see a hand therapist, as it is better to have your mallet injury supported and immobilised until you can get a custom-made mallet splint. If you have a mallet injury please mention it to the girls at the Health Nest reception so we can book your appointment as soon as possible.



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