Splinting versus extension-block pinning of bony mallet finger: a randomized clinical trial

Thillemann, Janni Kjærgaard; Thillemann, Theis Muncholm; Kristensen, Pia Kjær; Foldager-Jensen, Anders Ditlev; Munk, Bo

doi:10.1177/1753193420917567

Cited by 22 publications

(11 citation statements)

References 27 publications

(45 reference statements)

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“…[ 16 ] For bony mallet fingers, surgery is recommended, if the fracture fragment involves more than one-third of the joint and the distal phalanx is volar subluxated. [ 25 ] The EBT is widely used, as it is simple and minimally invasive. [ 1 , 2 , 16 , 18 , 19 ] In EBT, it is thought that prolonged immobilization of the DIP joint and damage to the cartilage of the joint by K-wires may lead to arthrosis and limitation of movement.…”

Section: Discussionmentioning

confidence: 99%

A new custom-made plate preparation method for bony mallet finger treatment and a comparison with extension block technique

et al. 2021

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Objectives In this study, we aimed to describe a new hook plate technique (HPT) and to compare our results with the conventional extension block technique (EBT) with a Kirschner wire (K-wire) for bony mallet finger treatment. Patients and methods Between April 2015 and January 2018, a total of 19 patients including 10 who were treated with EBT (7 males, 3 females; mean age: 30.1±7.3 years; range, 17 to 48 years) and nine who were treated with HPT (6 males, 3 females; mean age: 31.7±11.3 years; range, 19 to 42 years) for bony mallet finger with distal interphalangeal (DIP) joint subluxation and/or fracture fragment larger than one-third of distal phalanx (Wehbe-Schneider type 1/b, 2/a, 2/b, 3/a) joint were retrospectively analyzed. The DIP range of motion (ROM), Warren and Crawford scores, time to return to work/daily activity, operation time, the number of fluoroscopy shots, cost and complications were compared. Results No significant difference was found in the DIP ROM (p=0.708) and the Warren/Norris and Crawford scores (p=0.217 and p=0.175, respectively) between the two groups. Operation time and material cost were higher with HPT (p=0.006, p=0.001). There was no significant difference in the number of fluoroscopy shots (p=0.344). Although DIP joint motion was started at two weeks in the HPT group and at eight weeks in the EBT group, no significant difference was observed in the time of return to work and normal daily life in both groups (p=0.859). Complications were observed in two patients in the EBT group and in three patients in the HPT group. No significant difference in total complications was observed between the two groups (p=0.666). Conclusion Bony mallet finger treatment with a custom-made hook plate prepared from 1.3-mm AO plates appeared to be clinically and radiologically similar to EBT. Additionally, HPT had the advantages of allowing early ROM to DIP joint and eliminating the need for a secondary surgery such as K-wire removal. On the other hand, hardware cost with HPT was higher than EBT.

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Section: Discussionmentioning

confidence: 99%

A new custom-made plate preparation method for bony mallet finger treatment and a comparison with extension block technique

et al. 2021

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“…Існує декілька класифікацій, які стосуються цього перелому, однак найбільшу практичну цінність має класифікація Wehbé & Schneider (табл. 1) [8], виходячи з якої можна застосовувати відповідні методики лікування та спосіб розрахунку ступеня підвивиху і розміру фрагмента [7].…”

Section: вступunclassified

Lumbar Microdiscectomy. Retrospective Analysis of the Results of Treatment of 54 Patients

Uleshchenko

Stashkevych

Bublyk

et al. 2021

HOTP

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Summary. Although the microdiscectomy techniques for surgical treatment of a herniated disk are improved, the share of poor outcomes after the lumbar pain syndrome treatment remains high. Objective: to improve the outcomes of patients with lumbar spine osteochondrosis complicated with a herniated disk. Materials and Methods. The retrospective analysis of 54 patients with a lumbar herniated disk, who underwent surgical treatment from 2019 till 2020 at the Spine Surgery Department of the SI “Institute of Traumatology and Orthopedics of NAMS of Ukraine”. The age of patients varied from 23 to 78 years (mean age – 41.1±11.7 years). Results. We assessed the outcomes using VAS, Oswestry, and Nurick scales on the first day after the surgery, one month, and six months after it. VAS of the lower back pain syndrome declined on average from 5.9±1.59 to 3.4±1.55 on the first day after the surgery, to 1.7±1.1 in a month, and to 2.5±2.1 six months after the surgical treatment. The surgery eliminates radiculopathy and reduces radicular pain according to VAS on average from 8.5±1.17 to 1.3±1.04 on the first day after the surgery, to 1.5±1.0 in a month, and to 1.4±1.6 six months after it. The quality of life according to ODI improved on average from 74.4±5.12 before the surgery to 29.7±9.6 in a month and to 9.6±9.2 six months postoperatively. As of the discharge, 55.6% of patients demonstrated their nervous system's function recovered to the stage I and 38.9% – to the stage II. The long-term follow-up has shown positive dynamics in all the patients: the complete regress of neurologic symptoms in 74.4% and improved conditions – in 25.6% of patients. Conclusions. Surgical treatment of a herniated lumbar disk with the microdiscectomy method ensures the fulfillment of the fundamental nerve rootlet decompression by fenestrotomy, disctomy, or discectomy, and excision of the hernia, including sequestrated one. The positive dynamics of the pain syndrome scores, life quality, and neurological disorders is significant (р<0.05) and substantiates the efficiency of the treatment.

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“…Recent articles establish that this cut-off value is unreliable in predicting subluxation (Giddins, 2016; Kim and Kim, 2015; Moradi et al., 2017). In a randomized clinical trial, Thillemann et al. (2020) compared splinting with extension block pinning of displaced mallet fractures with a fragment larger than one-third of the articular surface but without initial subluxation.…”

Section: Bony Mallet Injuriesmentioning

confidence: 99%

Current methods, outcomes and challenges for the treatment of hand fractures

Boeckstyns¹

2020

J Hand Surg Eur Vol

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In treating hand fractures, we have to make a proper decision about conservative treatment versus surgical intervention and decide on individual surgical methods. This article reviews recent publications, technical advances, and outcome measures in treating metacarpal fractures, phalangeal fractures, complex fractures of the proximal interphalangeal joints, bony mallet fingers, and fractures of the thumb. My personal preferences and considerations are presented. At the end, the current challenges that hand surgeons are facing in treating frequent phalangeal and metacarpal fractures are discussed.

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Splinting versus extension-block pinning of bony mallet finger: a randomized clinical trial

Cited by 22 publications

References 27 publications

A new custom-made plate preparation method for bony mallet finger treatment and a comparison with extension block technique

A new custom-made plate preparation method for bony mallet finger treatment and a comparison with extension block technique

Lumbar Microdiscectomy. Retrospective Analysis of the Results of Treatment of 54 Patients

Current methods, outcomes and challenges for the treatment of hand fractures

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