2021
DOI: 10.1055/s-0040-1722181
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A Bony Mallet Thumb with Interposition of the Nail Plate

Abstract: Thumb extensor injuries and bony avulsion in the distal phalanx of the thumb are rare compared with other fingers. The most reported complications are infection, nail deformity, joint incongruity, implant failure, recurrent flexion deformity, and residual pain. This report presents a case of 30-year-old man suffering from an injury in the left thumb distal phalanx with a displaced comminuted intra-articular fracture of the distal phalanx of the left thumb. The nail plate was interposed between the dorsal and p… Show more

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Cited by 3 publications
(5 citation statements)
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“…Conservative treatment for a bony mallet thumb can also be considered, as demonstrated by some studies [ 4 , 5 ]; however, evidence is lacking. Regarding the surgical treatment for bony mallet injuries, including other fingers, direct pinning, extension block K-wire with direct pinning, compression pins, pullout wires, mini plates, hook plates, mini screws, tension band wiring, K-wire and suture, screw and suture, biodegradable implants [ 6 ], single extension block K-wire [ 7 ], nail plates [ 8 ], and two extension block K-wires [ 9 ], were indicated by previous studies. In the present case, we selected the Ishiguro extension block technique, which is generally used for bony mallet injuries of the other fingers [ 1 ].…”
Section: Discussionmentioning
confidence: 99%
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“…Conservative treatment for a bony mallet thumb can also be considered, as demonstrated by some studies [ 4 , 5 ]; however, evidence is lacking. Regarding the surgical treatment for bony mallet injuries, including other fingers, direct pinning, extension block K-wire with direct pinning, compression pins, pullout wires, mini plates, hook plates, mini screws, tension band wiring, K-wire and suture, screw and suture, biodegradable implants [ 6 ], single extension block K-wire [ 7 ], nail plates [ 8 ], and two extension block K-wires [ 9 ], were indicated by previous studies. In the present case, we selected the Ishiguro extension block technique, which is generally used for bony mallet injuries of the other fingers [ 1 ].…”
Section: Discussionmentioning
confidence: 99%
“…Because the thumb has a short and greater form and the extensor pollicis longus (EPL) tendon has a thick and strong structure, a mallet (tendinous and bony) thumb is uncommon [9]. In most reported cases, the injuries were caused by relatively high energy, machinery, or sports, and in some cases, open injuries [2][3][4][5][6][7][8][9]. However, in the present case, the fracture was caused by a fall from the standing position, a low-energy accident.…”
Section: Discussionmentioning
confidence: 99%
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“…Most surgeons recommend surgery for injuries involving more than one third of the articular surface and those with subluxation or displacement [20,21]. Regarding the bony mallet thumb injury, only few reports with a low level of evidence have been published using different surgical and nonoperative fixation methods (two extension block K-wires [25], a hook plate [27,36,40], a transverse mini-plate [42], biodegradable devices [1,28], an Ishiguro extension block technique [29], a direct K-wire pinning [9,33], compression fixation pins [43], an extension block pinning with direct pinning [13], a pull-out wire fixation [17,44], a screw fixation [2,8,12], tension band wiring [4], non-operative fixation [15], K-wire fixation with sutures [16] or K-wire, cast, splint, suture and screw fixation methods [31]).…”
Section: Introductionmentioning
confidence: 99%