Mallet fractures: a novel approach to internal fixation using a hook plate

J Hand Surg Eur Vol. 2007 Feb;32(1):24-30. doi: 10.1016/j.jhsb.2006.09.007. Epub 2006 Nov 28.

Abstract

A new treatment of mallet fractures of the distal phalanx is presented. Open reduction and internal fixation was performed using a "hook" plate fabricated from a 1.3 mm AO hand modular system straight plate. This technique avoids the need to place implants or wires through the small avulsion fragment while still being able to achieve a stable "tension-plate" type of fixation construct strong enough to allow protected early active motion of the distal interphalangeal joint. In minimising the need for prolonged splinting, patient comfort is also improved. In a consecutive series of nine fractures, union was achieved in all cases. At an average follow-up period of 17 months, four had excellent and five had good results using the Crawford rating scale. Using the Warren and Norris scale, all patients had a successful result. The final average active range of flexion of the distal interphalangeal joint was 64 degrees and there was no extensor lag.

MeSH terms

  • Adult
  • Athletic Injuries / diagnostic imaging
  • Athletic Injuries / surgery
  • Bone Plates*
  • Bone Screws
  • Equipment Design
  • Female
  • Finger Injuries / diagnostic imaging
  • Finger Injuries / surgery*
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation*
  • Fracture Healing / physiology
  • Humans
  • Male
  • Postoperative Complications / diagnostic imaging
  • Radiography
  • Titanium*

Substances

  • Titanium