title: Mallet fractures: a novel approach to internal fixation using a hook plate.
abstract: A new treatment of mallet fractures of the distal phalanx is presented. Open reduction and internal fixation was performed using a "hook" plate fabricated from a 1.3 mm AO hand modular system straight plate. This technique avoids the need to place implants or wires through the small avulsion fragment while still being able to achieve a stable "tension-plate" type of fixation construct strong enough to allow protected early active motion of the distal interphalangeal joint. In minimising the need for prolonged splinting, patient comfort is also improved. In a consecutive series of nine fractures, union was achieved in all cases. At an average follow-up period of 17 months, four had excellent and five had good results using the Crawford rating scale. Using the Warren and Norris scale, all patients had a successful result. The final average active range of flexion of the distal interphalangeal joint was 64 degrees and there was no extensor lag.
authors.affiliation: Department of Hand Surgery, Singapore General Hospital, Outram Road, Singapore 169608, Singapore. ghswly@sgh.com.sg
authors.forename: L C
authors.initials: LC
authors.lastname: Teoh
authors.forename: J Y L
authors.initials: JY
authors.lastname: Lee
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D001860:Bone Plates; D001863:Bone Screws; D004867:Equipment Design; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D014025:Titanium
chemical_list: D014025:Titanium