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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(06): e896-e904
DOI: 10.1055/s-0043-1771485
Artigo Original
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Fixation of Mallet Fractures Using a Modified Hook Plate Technique: A Prospective Case Series of 17 Patients[*]

Article in several languages: português | English
Hossam Abubeih 
1   Cirurgião Ortopédico, Departamento de Ortopedia, Assiut University Hospital, Assiut, Egito
,
Mohammed Anter Abdelhameed 
1   Cirurgião Ortopédico, Departamento de Ortopedia, Assiut University Hospital, Assiut, Egito
,
Mohamed Morsy 
1   Cirurgião Ortopédico, Departamento de Ortopedia, Assiut University Hospital, Assiut, Egito
,
Ahmed A. Khalifa 
2   Cirurgião Ortopédico, Departamento de Ortopedia, Qena Faculty of Medicine and University Hospital, South Valley University, Qena, Egito
,
Khaled Mohamed Mostafa
1   Cirurgião Ortopédico, Departamento de Ortopedia, Assiut University Hospital, Assiut, Egito
,
Galal Zaki Said
1   Cirurgião Ortopédico, Departamento de Ortopedia, Assiut University Hospital, Assiut, Egito
› Author Affiliations Financial Support The present study received no financial support from public, commercial, or not-for-profit sources.
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Abstract

Objective Various modalities have been suggested to manage mallet fractures; however, inappropriate treatment can lead to extension lag, a swan neck deformity, or arthritis of the distal interphalangeal joint (DIPJ). The current study aimed to evaluate the results (functional, radiological, and complications) of open reduction and internal fixation (ORIF) of mallet fractures using low-cost hook plates fabricated from low-profile titanium mini plates.

Methods A prospective case series of 17 consecutive patients (average age of 32.3 years) with mallet fractures (six were Wehbe Type IB and 11 were Wehbe Type IIB). Eleven (64.7%) were males. The affected hand was dominant in all patients, and the affected digit was the index in 6 (35.3%), the ring in 5 (29.4%), the small in 3 (17.65%), and the middle in 3 (17.65%) patients. The same fellowship-trained hand surgeon performed all surgeries.

Results The average operative time was 37.65 minutes. After an average follow-up of 10.94 months (range 6–27), the average DIPJ motion was 50° ° (range 20°–70°), the extensor lag was noted in 4 (23.5%) patients, and complications were reported in 6 (35.29%) patients. According to Crawford criteria, 6 (35.3%) patients achieved excellent results, 7 (41.2%) achieved good results, and 4 (23.5%) achieved fair results.

Conclusion The modified hook plate technique for fixation of mallet fractures is a beneficial, economical, yet demanding technique that adequately provides stable fixation to allow early DIPJ motion with acceptable functional outcomes.

Keywords

bone plates - finger injuries - finger joint - fractures, bone - fracture fixation, internal

* Study developed at the Orthopaedic Department, Assiut University Hospital, Assiut, Egypt.




Publication History

Received: 09 August 2022

Accepted: 07 February 2023

Article published online:
24 October 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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