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Journal of the Korean Society for Surgery of the Hand 2008;13(4):288-293.
Published online December 1, 2008.
Mallet Fracture of Percutaneous Smallscrew Fixation after Closed Reduction
Hyun-Dae Shin, Kyung-Cheon Kim, Jae-Hoon Yang, Bo-Kun Kim
도수정복 후 경피적 소형나사로 고정을 한 추지 골절
신현대, 김경천, 양재훈, 김보건
To evaluate the clinical results of closed reduction and percutaneous internal small screw fixation in mallet fracture. Materials and Methods: The subjects were 9 patients who underwent small screw fixation using closed reduction after being diagnosed with bony mallet finger from March 2005 to February 2006. The indication for surgery was the fragment including at least one-third of the distal interphalangeal joint articulation. After 6 to 12 months of follow up, the amount of pain, appearance, function, and satisfaction of the patient was assessed using the VAS scale. The range of motion of the distal interphalangeal joint was compared with the normal side, and the range of joint motion was assessed using the Crawford’s criteria. The change in the interphalangeal joint was observed using radiologic studies. Results: Eight out of nine patients showed satisfactory results in the VAS scale with no limitation of extension, joint stiffness, or skin necrosis. The Crawford’s criteria showed 5 patients with excellent results, 3 with good results, and 1 with poor results. The patient with the poor result seemed to be due to loss of reduction 8 weeks after operation, and pull out suture and K-wire fixation on DIP joint was done. Seven out of eight patients (except 1 pateint who had loss of reduction) showed normal radiographic results, and one patient showed a decrease in the joint space. Conclusion: Closed reduction and percutaneous internal small screw fixation seems to be a recommended method of treating mallet fracture of which the fragment includes at least one-third of the distal interphalangeal joint articulation

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