Bony Mallet Repair — Zone I Mallet Finger Repair — K-Wire Pinning

UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation

Weight-Bearing

NWB surgical UE

Key Restrictions

No aggressive gripping/pinching with involved digit; no lifting >5 lbs involved UE; no PROM of DIPJ; pin care required

Timeline & Phases

Phase I (initial to 6–8 wks): DIP orthosis to protect pin and maintain available extension; pin care; AROM/PROM PIP and MP; daily skin checks; adjust orthosis as needed if pin removed before 6 wks post-op | Phase II (6–8 wks): AROM all joints of involved finger; DIP blocking AROM; wean daytime orthosis over 2 wks (1 hr/day increments); continue night orthosis 2 wks; no PROM DIPJ | Phase III (10–12 wks): return to all activities; strengthening as needed; D/C orthosis

Notes

Indication: bony mallet requiring surgical K-wire pinning; pin care throughout Phase I; same orthosis weaning schedule as conservative protocol; expected outcome: 10–15° extension lag acceptable; >20° lag = additional 2 wks full-time orthosis; shared URL with Conservative protocol; developed collaboratively by UW Health and UnityPoint Health - Meriter Rehabilitation