[The operative treatment of the dorsal distal phalanx near to the base (osseous pull out of the extensor tendon) with extreme exposure of the hand by athletic activities - is the hook plate a option for treatment?].
OBJECTIVE
Aim of the presented investigation was to work out the short- and mid-term outcomes after operative treatment of distal phalanx fractures near to the base of type Doyle IVb and IVc (osseous pull out of the extensor tendon) by means of a hook plate in patients with extreme exposure of the hand by athletic activities.


METHODS
Between February 2002 and September 2009 77 patients were treated by operation in our hospital by means of a hook plate due to a traumatic fracture of the dorsal distal phalanx near to the base of type Doyle IVb and IVc (osseous pull out of the extensor tendon) by means of a hook plate (Aerni plate/S2-Prong-Plate) of Stryker Leibinger. 64 of these 77 patients incur the fracture while exercising sport. 46 of these 64 patients were clinically and radiologically followed up within a retrospective study. To assess the therapy's outcome a specific scoring scheme containing subjective and objective parameters was elaborated in order to gain a transparent result of the treatment.


RESULTS
According to this scoring scheme 84.79 % of the patients reached a very good or good result. Nail growth defects by an intraoperative injury of nail matrix represents an essential complication of the presented surgical method.


CONCLUSIONS
By means of the presented method in the majority of the cases good or very good results could be achieved. That method represents a simple, safe and less complicate possibility to treat the distal phalanx fractures near to the base type IVb and IVc according to Doyle and it is considered as a useful alternative to other procedures.
Szalay
Gabor
G
Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Gießen und Marburg, Standort Gießen, Gießen. Gabor.Szalay@chiru.med.unigiessen.de
Schleicher
I
I
Kraus
R
R
Stigler
B
B
Schnettler
R
R
D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D001860:Bone Plates; D004867:Equipment Design; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009262:Nails / Q000293:injuries; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D012189:Retrospective Studies; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D014025:Titanium; D055815:Young Adult
D014025:Titanium