Functional outcomes and complications of hook plate for bony mallet finger: a retrospective case series study

BMC Musculoskeletal Disorders

Tsung-Yu Ho¹  Cheng-En Hsu²  Chen-Wei Yeh³  Yung-Cheng Chiu⁴  Wei-Chih Wang⁴ 

[1] Department of Orthopedic Surgery, China Medical University Hospital, No. 2, Yude Road, North District, Taichung City, 404472, Taichung, Taiwan, Taiwan;Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan;Sports Recreation and Health Management Continuing Studies-Bachelor’s Degree Completion Program, Tunghai University, 407, Taichung, Taiwan;School of Medicine, China Medical University, Taichung, Taiwan;School of Medicine, China Medical University, Taichung, Taiwan;Department of Orthopedic Surgery, China Medical University Hospital, No. 2, Yude Road, North District, Taichung City, 404472, Taichung, Taiwan, Taiwan;

关键词: Mallet fracture;    Bony mallet finger;    Open reduction and internal fixation;    Implant problems;    Nail bed deformity;    Screw loosening;   

DOI  :  10.1186/s12891-021-04163-2

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsThe 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.ResultsSixteen 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.ConclusionsDespite 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.

【 授权许可】

CC BY