Mallet finger and fractures

Mallet finger is often associated with a dorsal fracture of the base of the terminal phalanx. This is sometimes referred to as a mallet finger fracture but such a term is unwise because it may be applied to all fractures in this position. The purpose of this paper is to justify this warning and to distinguish between such fractures with and without mallet finger. However treated, mallet finger, with or without fracture, often leads to persistent loss of some active extension of the finger. In 11 cases of fracture without mallet finger in which there was no subluxation, full function was regained by comfortable support and early activity; operation was not required. In 2 cases with subluxation, the joint became stiff and open fixation may lead to a better result.     

Ishiguro 法治疗指伸肌腱撕脱骨折

目的介绍用Ishiguro法治疗指伸肌腱撕脱骨折并评估其临床疗效.方法应用Ishiguro 法治疗10例指伸肌腱撕脱骨折,术后6周拔除克氏针并随访半年,对远侧指间关节的屈伸活动范围及X线片表现进行评价.结果 10例患指远侧指间关节的平均主动活动范围为72°,无并发症发生.结论 Ishiguro 法是目前治疗骨块超过关节面1/3的指伸肌腱撕脱骨折的理想方法,操作简单、疗效可靠.     

单根克氏针加压技术治疗Mallet骨折

目的探讨应用单根克氏针加压技术治疗Mallet骨折的方法及疗效，分析总结治疗时限适应证和治疗方法的选择。方法2004年8月～2006年6月，应用单根克氏针加压技术治疗25例Mallet骨折患者，其中ⅠB型18例，ⅡB型7例。根据骨折的新旧程度选择治疗方法，新鲜骨折16例，采用闭合复位单根克氏针加压技术固定；陈旧性骨折9例，行切开复位单根克氏针加压技术固定。结果所有患者术后获2～22个月（平均12个月）随访。25例患者骨折均顺利愈合，平均愈合时间为5周。术后疼痛程度和关节屈伸活动度评价：优14例，良8例，可2例，差1例，优良率为88．0％。术后未发生严重并发症。结论应用单根克氏针加压技术治疗Mallet骨折具有方法简单、损伤小、固定可靠等优点，并可减少内固定的数目，缩短骨折愈合时间，有效降低术后关节疼痛和关节活动受限。     

经甲下克氏针压迫复位技术治疗Mallet骨折

目的 介绍一种治疗Mallet骨折的新方法. 方法 自2003年3月至2007年7月,采用远侧指间(DIP)关节背侧切口,将1枚克氏针从甲床与指骨间顺行自指尖穿出,骨块复位后,过伸DIP关节将克氏针逆行打入中节指骨,然后屈曲DIP关节,弯曲的克氏针压迫骨折块,使之维持复位状态.共治疗Mallet骨折17例. 结果 17例骨折均于术后4周临床愈合,9例得到随访,随访时间4～54个月(平均16个月),采用Crawford法进行疗效评定:优2例,良4例,可3例,差0例.结论 该方法 不损伤关节软骨,避免了骨块碎裂,简单易行、疗效可靠,是治疗Mallet骨折的较好方法.     

应用钩钢板内固定技术治疗mallet骨折

目的 介绍应用钩钢板内固定技术治疗mallet骨折的手术方法 及疗效.方法 2006年8月-2008年2月,应用钩钢板内固定技术治疗25例mallet骨折患者,其中Ⅰ B型18例,ⅡB型7例.采用2.0 mm Medicon微型直钢板制备1孔钩钢板,切开复位内固定骨折,术后行限制性远指间关节早期功能锻炼.结果 所有患者术后获2～18个月(平均10个月)随访,骨折均顺利愈合,愈合时间平均5周.术后疼痛程度和关节屈伸活动度评价:优14例,良9例,可2例,差0例;优良率为92%.术后未发生严重并发症.结论 应用钩钢板切开复位内固定技术治疗mllet骨折,复位牢固可靠,内固定物不固定骨折块和关节,允许早期关节活动,有效降低术后关节疼痛和关节活动受限,是治疗撕脱骨折块大于末节指骨基底关节面1/3 mallet骨折的有效方法 .     

Mallet thumb

The uncommon injury of mallet thumb is described, with four case reports. In diagnosis the condition must be distinguished from dropped thumb. Operative treatment is advised which, in this small series, gave excellent results.     

Mallet finger

Mallet finger involves loss of continuity of the extensor tendon over the distal interphalangeal joint. This common hand injury results in a flexion deformity of the distal finger joint and may lead to an imbalance between flexion and extension forces more proximally in the digit. Mallet injuries can be classified into four types, based on skin integrity and the presence or absence of bony involvement. Although various treatment protocols have been proposed, splinting of the distal interphalangeal joint for 6 to 8 weeks has yielded good results while minimizing morbidity in the majority of patients. Surgical management may be considered for acute and chronic mallet lesions in patients who have failed nonsurgical treatment, are unable to work with the splint in position, or have a fracture involving more than one third of the joint surface.     

Mallet thumb

A case of mallet thumb, with a closed rupture of the extensor pollicis longus at its distal insertion, is presented. Conservative treatment resulted in a near normal function.     

Mallet toe deformity

Mallet toe is one of the most common deformities encountered by orthopedic surgeons. Care needs to be taken to ascertain whether it is a primary condition or secondary to a systemic disease, especially if multiple deformities are present. There are numerous operative strategies available, but each has its specific indications. If the indications are followed, highly successful outcomes may be achieved.     

Mallet deformity in sport

During a four month period 851 patients presented to the Edinburgh Orthopaedic Trauma Unit with an acute sporting injury. Eighteen (2%) patients had either a soft tissue or bony mallet deformity. Six different sports were identified with rugby accounting for eight of the 18 mallet deformities. All patients were treated with splintage. Fourteen patients returned questionnaires regarding subjective digit function following treatment and nine patients claimed excellent function. The average splinting time for this group was 6 weeks and sports were avoided for an average of 5 weeks.Mallet deformity accounts for a minority of sporting injuries, but excellent functional outcome can be achieved with splintage and avoidance of the causative sport while splinted.