Mallet Fractures of the Thumb Compared With Mallet Fractures of the Fingers

Abstract

Background: The purpose of this study was to look for differences in mechanism, radiographic findings, and treatment between mallet fractures of the thumb and mallet fractures of the index through small fingers. Methods: This retrospective study included 24 mallet fractures of the thumb and 392 mallet fractures of other digits. We compared demographics, injury factors (side, dominant hand, time between injury and first visit, and injury mechanism), subluxation, fragment size, treatment, and time from injury to final evaluation between the 2 groups. Results: Mallet fractures of the thumb presented for treatment sooner after injury (2.9 vs 13 days on average), had less fragment displacement (27% vs 33%), and less articular involvement (39% vs 46% on average). None of the mallet fractures of the thumb had radiographic evidence of subluxation, whereas 25% of mallet fractures of other fingers had initial or later subluxation. Conclusions: Mallet fractures of the thumb are not likely to subluxate.

A Bony Mallet Thumb with Interposition of the Nail Plate

“… 4 7 8 The bony mallet thumb is an even rarer lesion. 3 A bony mallet finger refers to an avulsion of the extensor tendon from the distal phalanx with a fragment of bone attached to the avulsed tendon. 1 The most common mechanism of a bony mallet finger is an axial force followed by sudden extreme hyperextension of the DIP joint.…”

“…Although these various techniques resulted in excellent functional outcomes, the authors' successful experiences were limited to a few cases of bony mallet thumb. 3 4 6 7 8 The complication rate of surgical treatment has been reported up to 53%. The probable serious complications are hardware-associated infections, osteoarthritis, stiffness, nail dystrophy, and skin necrosis.…”

“…But surgical treatments are recommended in patients with fragment or distal phalanx dislocations. 1 2 3 The common complications associated with conservative treatments and splint occur in approximately 45% of the cases. The frequent complications of surgical treatments are infection, nail deformity, joint incongruity, implant failure, nail deformity, recurrent flexion deformity, and residual pain.…”

“…The frequent complications of surgical treatments are infection, nail deformity, joint incongruity, implant failure, nail deformity, recurrent flexion deformity, and residual pain. 1 3 Here, we present a case of a patient with interposition of the nail plate in the fracture site.…”

Pathologic Fractures in Benign Neoplasms of the Fingers

“…However, differences in tendon attachments, lack of the middle phalanx, and a relatively broader bone make it more stable. 16,17…”