Treatment of Mallet fractures with internal fixation using hook plate technique

Abstract

Objective To introduce the surgical techniques and clinical outcomes of trestment of Mallet fractures using hook plate internal fixation. Methods From August 2006 to February 2008, 25 cases of Mallet fractures were treated with hook plate internal fixation. There were 18 cases of Ⅰ B type fractures and 7 cases of Ⅱ B type fractures. Open reduction and internal fixation was performed using a one-hole hook plate fabricated from a 2.0 mm Medicon straight plate. Early postoperative protected motion of the distal interphalangeal (DIP) joint was allowed. Results All the cases were followed up for 2 to 18 months, with an average of 10 months. All the fractures healed successfully, with an average bone union time of 5 weeks. Functional evaluation included degree of pain and DIP joint flexion and extension. The results were rated as excellent in 14 cases, good in 9 cases, fair in 2 cases and poor in 0 case. The overall good-excellent rate was 92%. There were no postoperative complications. Conclusion Treatment of Mallet fractures with hook plate internal fixation technique can achieve more tellable fixation than conventional methods. This technique avoids placing implants or wires through the small avulsion fragment and the DIP joint while still being able to achieve a stable fixation construct strong enough to allow protected early active motion of the DIP joint. In minimizing the need for prolonged sprinting, patient comfort is also improved . It is an effective method for treatment of Mallet fractures involving more than one-third of the base of the distal phalanx. Key words: Fracture fixation; Internal fixators; Mallet fractures