Mallet fracture reduction:Fragment vs. Phalanx

Amir R. Kachooei, MDAli Moradi, MD

Chaitanya S. Mudgal, MD

Introduction

Tension Wire FixationJupiter 1987

ISHIGURO EXTENSION BLOCK: Japan.1988

Compression fixation pin: Japan

K. YAMANAKA and T. SASAKI. JHS.1999

External Fixation: Turkey, JHS.2003

Open Reduction Screw Fixation

S. C. KRONLAGE and D. FAUST. JHS. 2004

Single K-Wire CompressionD. FRITZ. JHS. 2005

Umbrella Handle:Italy, JHS.2006

Hook PlateSingapore, JHS. 2007

Pull-out WireZhang, China.2010

Methods

16 y.o female after basketball injury

Wire in for 6 wks 2 month f/u

2 month f/u

3 month f/u

ResultsPatients Data

Patient Age, y Sex Digit Injury Side

Injury mechanism

Surgery timing, d Pin Size Splint

Pin removed,

dPin site Fragment

SizeFollow-up,

mo flexion extension

1 47 M Small L Sport 8 0.045 Yes 56 redness 45% 3

2 17 M Small R Sport 56 0.045 Yes 47 OK 48% 8 full full

3 16 F Middle R Sport 47 0.045 Yes 46 OK 43% 3 full full

Data from Previous Study

1 44 F Small L Sport 5 0.045 Yes 38 OK Ave 52% 6 0 65

2 15 M Middle L Sport 22 0.045 Yes 43 OK Ave 52% 4 0 80

3 28 M Ring L Sport 56 0.045 Yes 44 OK Ave 52% 19 0 85

Conclusion

1. Closed reduction and IF with single K-wire has satisfactory outcome.

2. Anatomic reduction is not necessary for type IIb mallet fractures.

3. Joint subluxation should be addressed when present.

Thank you