Problems of Diagnosis, Conservative Treatment and Long-Term Results of “Mallet Finger” Fracture
ARTICLE PDF (Українська)

Keywords

“mallet finger” deformity; “mallet finger” fracture; “mallet finger”; Bush fracture; avulsive fracture; distal phalanx; finger; distal interphalangeal joint.

How to Cite

Bezuhlyi, A., & Lysak, A. (2021). Problems of Diagnosis, Conservative Treatment and Long-Term Results of “Mallet Finger” Fracture. Herald of Orthopaedics, Traumatology and Prosthetics, (2(109), 42-50. https://doi.org/10.37647/0132-2486-2021-109-2-42-50

Abstract

Summary. Distal phalanx dorsal edge fracture is treated in a relatively simple closed manner during the first weeks after injury. The role of the distal interphalangeal joint in the upper extremity integral function reaches conventionally only a few percent. This may lead to insufficient attention and a large number of mistakes in diagnosis and treatment of such injuries, which in turn provokes complications that are much more difficult to treat than the primary injury. This article considers the most common problems of diagnosis and treatment of “mallet finger” fractures. Advantages and disadvantages of various techniques used in the treatment of such fractures in acute and neglected cases are considered and analyzed.

Objective: to study the effect of distal phalanx dorsal edge avulsive fractures on function of the upper limb, quality of life, and depression rate in long term period after injury.

Materials and Methods. Data from 11 patients (8 (88%) males and 3 (12%) females) with neglected cases of distal phalanx dorsal edge avulsive fractures were studied. QuickDASH questionnaire and visual analog scales were used to study impaired quality of life and depression rate in such patients. Indicators that lead to the need for surgery in long term period after injury have been identified.

Results. It was determined that in long term period, in patients with a “mallet finger” fracture, function of the upper extremity suffered significantly and was 29.2±20.2 points (range 2.3-75) according to QuickDASH scale. This condition also significantly affected the general well-being of the patient. Average value of impaired quality of life was 43.6±24.6 (range 0-90 points), and depression rate due to upper extremity dysfunction was 44.6±22.7 (range 0-90 points).

Conclusions. Despite the relatively minor injury, high rates of dysfunction, impact on quality of life and depression rate indicate the need to restore finger function even in long term period after injury.

https://doi.org/10.37647/0132-2486-2021-109-2-42-50
ARTICLE PDF (Українська)

References

Boeckstyns MEH, Richter M. Fractures of the hand and carpus: FESSH 2018 instructional course book. Stuttgard, New York, Delhi, Rio de Janeiro:Thieme; 2018. 278 p.

Giddins GE. Bony mallet finger injuries: assessment of stability with extension stress testing. Journal of Hand Surgery (European Volume). 2016;(417):696-700. DOI: 10.1177%2F1753193416647307.

Ishiguro T, Itoh Y, Yabe Y, Hashizume N. Extension Block with Kirschner Wire for Fracture Dislocation of the Distal Interphalangeal Joint. Techniques in Hand & Upper Extremity Surgery. 1997;1(2):95-102.

Light TR. Buttress pinning techniques. Orthop Rev.1981;(10):49-55.

McMinn DJW. Mallet finger and fractures. Injury. 1981;(12):477-9.

Tetik C, Gudemez E. Modification of the extension block Kirschner wire technique for malletfractures. Clin Orthop 2002;404:284-89. DOI: 10.1097/01.blo.0000030174.56585.41.

Thillemann JK, Thillemann TM, Kristensen PK, Foldager-Jensen AD, Munk B. Splinting versus extension-block pinning of bony mallet finger: a randomized clinical trial. Journal of Hand Surgery (European Volume). 2020;45(6):574-81. DOI: 10.1177%2F1753193420917567.

Wehbé MA, Schneider LH. Mallet fractures. Journal of Bone and Joint Surgery. 1984;66A:658-69.

Беспальчук ПИ, Ван Ф. Хирургическое лечение переломов Буша. В: Лашковский ВВ, ответственный редактор. Развитие травматологии и ортопедии на современном этапе. Сб. материалов обл. юбилейной науч.-практ. конф. с междунар. участием, посвященной 50-летию с момента организации специализированной ортопедо-травматологической помощи в Гродн. обл.; 2016 апр. 15; Гродно: ГрГМУ; 2016.с .24-26.

Bespalchuk PI, Van F. Surgical treatment of Bush fractures. V: Lashkovskiy VV, otvetstvennyy redaktor. The development of traumatology and orthopedics at the present stage. Sb. materialov obl. yubileynoy nauch.-prakt. konf. s mezhdunar. uchastiem, posvyashchennoy 50-letiyu s momenta organizatsii spetsializirovannoy ortopedo-travmatologicheskoy pomoshchi v Grodn. obl.; 2016 apr. 15; Grodno: GrGMU; 2016.s .24-26. [in Russian].

Голобородько СА. Закрытые отрывные переломы дистальных фаланг пальцев кисти (описание случая). Клиническая хирургия. 1994;(11):76.

Goloborodko SA. Closed avulsion fractures of the distal phalanges of the fingers (case report). Klinicheskaya khirurgiya. 1994;(11):76. [in Russian].

Золотов АС. Лечение повреждений дистальных отделов пальцев кисти, приводящие к молоткообразной деформации. Иркутск: Научный центр реконструктивной и восстановительной хирургии Сибирского отделения РАМН; 2010. 236 с.

Zolotov AS. Treatment of damage to the distal fingers of the hand, leading to hammer deformity. Irkutsk: Nauchnyy tsentr rekonstruktivnoy i vosstanovitelnoy khirurgii Sibirskogo otdeleniya RAMN; 2010. 236 s. [in Russian].

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