Operative treatment of osseous pull out of the extensor tendon using a hook plate

Anatomical reposition and stabilization of dorsal distal phalanx fractures with a hook plate. Dislocated mallet fractures type Doyle IVb with dislocation of the fragment by more than 2 mm and/or tilting of the fragment as well as dislocation of the dorsal distal phalanx fractures type Doyle IVc. Flo...

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Bibliographic Details
Published in:Operative Orthopädie und Traumatologie 2011-04, Vol.23 (2), p.151-157
Main Authors: Szalay, G, Schleicher, I, Schiefer, U-R, Alt, V, Schnettler, R
Format: Article
Language:ger
Subjects:
Adolescent
Adult
Aged
Bone Plates
Bone Screws
Female
Finger Injuries - diagnostic imaging
Finger Injuries - surgery
Finger Joint - diagnostic imaging
Finger Joint - surgery
Finger Phalanges - diagnostic imaging
Finger Phalanges - injuries
Finger Phalanges - surgery
Follow-Up Studies
Fracture Fixation, Internal - instrumentation
Fracture Healing - physiology
Humans
Intra-Articular Fractures - diagnostic imaging
Intra-Articular Fractures - surgery
Joint Dislocations - diagnostic imaging
Joint Dislocations - surgery
Male
Middle Aged
Postoperative Care
Postoperative Complications - etiology
Radiography
Splints
Surgical Instruments
Young Adult
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Summary:Anatomical reposition and stabilization of dorsal distal phalanx fractures with a hook plate. Dislocated mallet fractures type Doyle IVb with dislocation of the fragment by more than 2 mm and/or tilting of the fragment as well as dislocation of the dorsal distal phalanx fractures type Doyle IVc. Florid inflammation of and injuries to the soft tissues in the operation area. Dorsal approach to the distal interphalangeal joint (Y-, S-, H-shaped). Preparation of the fragment, cleaning the fracture gap, repositioning of the fragment, mounting of the plate, placing the screw. Controlling by image converter. Suture of the skin; tape. Stack splint for 4 weeks. After week 3, start with exercising of the distal interphalangeal joint within the splint. Physiotherapy is usually not required. Full exertion after 6-8 weeks is possible. The period of inability to work is dependent on the patient's occupation. Due to the danger of perforation and infection, it is recommended that the plate be removed after 3-6 months. From February 2002 to September 2009, 77 mallet fractures type Doyle IVb and IVc were operatively stabilized with a hook plate. In a retrospective study, 59 patients were followed up at a mean interval of 38.3 (3-69) months after the operation. Wound healing problems or inflammation were not observed. Visible disturbances of nail growth were macroscopically seen in 11.9%. Results were very good in 35 patients (59.3%), good in 16 patients (27.1%), sufficient in 5 patients (8.5%), satisfying in 1 patient (1.7%), and insufficient in 2 patients (3.4%).
ISSN:1439-0981
DOI:10.1007/s00064-010-0008-4