Comparison Between Y- and S-Shaped Incisions for Open Reduction and Hook-Plate Fixation of the Mallet Finger

Abstract Background The treatment of mallet fracture using hook plate fixation was first introduced in 2007 and has subsequently shown excellent outcomes. Common complications, such as nail deformity and screw loosening, have also been reported. Very few studies have focused on these common complications or their prevention. In this study, we present the clinical outcomes and complications of our case series and describe the pitfalls and detailed solution of surgical tips to avoid common complications related to this procedure. Methods The retrospective case series of 16 patients with mallet fractures who underwent open reduction and hook plate fixation in our hospital from 2015 to 2020 were retrospectively reviewed. Data on extension lag, range-of-motion (ROM) of the distal interphalangeal joint (DIP) joint, the Disabilities of the Arm, Shoulder, and Hand (DASH) score, and surgical complications were collected and analysed. The clinical outcome was graded according to the Crawford mallet finger criteria. Results Sixteen patients were included in our analysis. The median DIP extension lag was 0° (range, 0° to 30°) and the median active DIP flexion angle was 60° (range, 40° to 90°). The median DASH score was 0 (range, 0–11.3). Fourteen patients with good and excellent results were satisfied with this treatment. The Complication rate in our patient series was 18%. Common complications reported in articles included wound necrosis, extension lag, nail deformity, and plate loosening. Conclusions Despite the fact that the treatment of mallet fracture with hook plate fixation has satisfactory functional outcomes, pitfalls, including iatrogenic nail germinal matrix injury, unnecessary soft tissue dissection, and insufficient screw purchase, were still reported. To avoid complications, we suggest modifications of the skin incision, soft tissue dissection, and screw position.

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Clinical outcomes after mini-hook plate fixation for small avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02339-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Jung Il Lee ◽

Ki-Chul Park ◽

Hyun Soo So ◽

Duk Hee Lee

Keyword(s):

Clinical Outcomes ◽

Plate Fixation ◽

Hook Plate ◽

Joint Stability ◽

Avulsion Fractures ◽

Metacarpophalangeal Joints ◽

Early Results ◽

Mallet Fracture ◽

Osseous Union ◽

Central Slip

Abstract Background Mini-hook plate has been described for the treatment of various small avulsion fragments in the hand. This retrospective study aimed to evaluate clinical outcomes after mini-hook plate fixation in patients with an avulsion fracture around the interphalangeal or metacarpophalangeal joints of the hand. Methods Nineteen patients with avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand were included in this study. Seven patients had a mallet fracture, and 12 patients had other phalangeal avulsion fractures including central slip, collateral ligament, volar plate, and flexor avulsion fractures. The osseous union and functional outcomes, including finger joint motion, joint stability, pinching strength, and the disabilities of the arm, shoulder, and hand score, were evaluated. Results The mean duration of follow-up was 33.8 months. All patients in mallet and other phalangeal avulsion fractures achieved osseous union between the avulsion fragment and phalangeal bone, and there was no joint subluxation. There were no significant differences in the disabilities of the arm, shoulder, and hand scores. However, the patients with mallet fracture have lower mean percentage values of the total active range of motion and pinching strength than other phalangeal avulsion fractures. We abandoned this procedure in mallet fractures because the early results after mini-hook plate fixation in mallet fractures appeared unfavorable. Conclusion These results suggest that the mini-hook plate fixation can provide sufficient stability and good clinical outcomes in those with phalangeal avulsion fractures. However, the outcomes for mallet fractures were not as good as those for other phalangeal avulsion fractures.

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Arthroscopic-assisted hook plate fixation for acromioclavicular joint dislocation

International Orthopaedics ◽

10.1007/s00264-012-1691-6 ◽

2012 ◽

Vol 37 (1) ◽

pp. 77-82 ◽

Cited By ~ 11

Author(s):

Justus Gille ◽

Gerhard Heinrichs ◽

Andreas Unger ◽

Helge Riepenhof ◽

Jan Herzog ◽

...

Keyword(s):

Acromioclavicular Joint ◽

Plate Fixation ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Joint Dislocation

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Factors Affecting the Occurrence of Late Median Nerve Neuropathy After Open Reduction and Volar Locking Plate Fixation of Distal Radius Fracture

Orthopedics ◽

10.3928/01477447-20210414-08 ◽

2021 ◽

Vol 44 (3) ◽

Author(s):

Jae Hoon Lee ◽

Kyu Jin Kim ◽

Jong Hun Baek

Keyword(s):

Median Nerve ◽

Distal Radius Fracture ◽

Distal Radius ◽

Open Reduction ◽

Locking Plate ◽

Plate Fixation ◽

Volar Locking Plate ◽

Locking Plate Fixation ◽

Factors Affecting ◽

Median Nerve Neuropathy

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Displaced Epiphyseal Plate of the Terminal Phalanx in a Child

HAND ◽

10.1016/s0072-968x(80)80029-5 ◽

1980 ◽

Vol os-12 (1) ◽

pp. 51-53 ◽

Cited By ~ 15

Author(s):

E. Michelinakis ◽

H. Vourexaki

Keyword(s):

Open Reduction ◽

Extensor Tendon ◽

Normal Growth ◽

Epiphyseal Plate ◽

Mallet Finger

A case of mallet finger in a child is described. The epiphysis of the terminal phalanx was displaced dorsally with the extensor tendon attached to it, and was first diagnosed two weeks after injury. The treatment was by open reduction. Radiograph three years later showed that a satisfactory position of the epiphysis and normal growth of the terminal phalanx had occurred.

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Clinical and Radiological Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocations and Distal Clavicle Fractures

Clinics in Shoulder and Elbow ◽

10.5397/cise.2018.21.2.95 ◽

2018 ◽

Vol 21 (2) ◽

pp. 95-100

Author(s):

Joo Han Oh ◽

Seunggi Min ◽

Jae Wook Jung ◽

Hee June Kim ◽

Jae Yoon Kim ◽

...

Keyword(s):

Plate Fixation ◽

Clavicle Fracture ◽

Hook Plate ◽

Distal Clavicle ◽

Ac Joint ◽

Joint Dislocation ◽

Group I ◽

Joint Dislocations ◽

Ac Joint Dislocation ◽

Group Ii

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures.METHODS: We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications.RESULTS: At the removal, the pain VAS was 2.69 ± 1.30 and 4.10 ± 2.14 in groups I and II, respectively, which were significantly different (p=0.003). The simple shoulder test score was 9.59 ± 1.60 and 7.81 ± 2.67 in groups I and II, respectively, which were also significantly different (p=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (p=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant.CONCLUSIONS: Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.

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