1
|
Abubeih H, Abdelhameed MA, Morsy M, Khalifa AA, Mostafa KM, Said GZ. Fixation of Mallet Fractures Using a Modified Hook Plate Technique: A Prospective Case Series of 17 Patients. Rev Bras Ortop 2023; 58:e896-e904. [PMID: 38077774 PMCID: PMC10708977 DOI: 10.1055/s-0043-1771485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/07/2023] [Indexed: 07/30/2024] Open
Abstract
Objective Various modalities have been suggested to manage mallet fractures; however, inappropriate treatment can lead to extension lag, a swan neck deformity, or arthritis of the distal interphalangeal joint (DIPJ). The current study aimed to evaluate the results (functional, radiological, and complications) of open reduction and internal fixation (ORIF) of mallet fractures using low-cost hook plates fabricated from low-profile titanium mini plates. Methods A prospective case series of 17 consecutive patients (average age of 32.3 years) with mallet fractures (six were Wehbe Type IB and 11 were Wehbe Type IIB). Eleven (64.7%) were males. The affected hand was dominant in all patients, and the affected digit was the index in 6 (35.3%), the ring in 5 (29.4%), the small in 3 (17.65%), and the middle in 3 (17.65%) patients. The same fellowship-trained hand surgeon performed all surgeries. Results The average operative time was 37.65 minutes. After an average follow-up of 10.94 months (range 6-27), the average DIPJ motion was 50° ° (range 20°-70°), the extensor lag was noted in 4 (23.5%) patients, and complications were reported in 6 (35.29%) patients. According to Crawford criteria, 6 (35.3%) patients achieved excellent results, 7 (41.2%) achieved good results, and 4 (23.5%) achieved fair results. Conclusion The modified hook plate technique for fixation of mallet fractures is a beneficial, economical, yet demanding technique that adequately provides stable fixation to allow early DIPJ motion with acceptable functional outcomes.
Collapse
Affiliation(s)
- Hossam Abubeih
- Cirurgião Ortopédico, Departamento de Ortopedia, Assiut University Hospital, Assiut, Egito
| | | | - Mohamed Morsy
- Cirurgião Ortopédico, Departamento de Ortopedia, Assiut University Hospital, Assiut, Egito
| | - Ahmed A. Khalifa
- Cirurgião Ortopédico, Departamento de Ortopedia, Qena Faculty of Medicine and University Hospital, South Valley University, Qena, Egito
| | - Khaled Mohamed Mostafa
- Cirurgião Ortopédico, Departamento de Ortopedia, Assiut University Hospital, Assiut, Egito
| | - Galal Zaki Said
- Cirurgião Ortopédico, Departamento de Ortopedia, Assiut University Hospital, Assiut, Egito
| |
Collapse
|
2
|
Heo JW, Whang JI, Park HS. Variable Adjustment Methods for Hemihamate Autograft Arthroplasty in Proximal Interphalangeal Joint Fracture/Dislocations: A Surgical Technique Revisited and Case Series. Ann Plast Surg 2023; 91:720-725. [PMID: 37856229 DOI: 10.1097/sap.0000000000003695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
ABSTRACT Proximal interphalangeal joint fracture/dislocations, even after surgical correction, often lead to long-term complications including posttraumatic arthritis, prolonged joint stiffness, and chronic joint instability. A wide range of surgical techniques has been devised to resolve this issue, but none has been promising enough. Despite this circumstance, arthroplasty using a hemihamate autograft of size and contour that match the middle phalangeal base has progressed into one of more acceptable methods that provide both articular congruency and osseous stability. In this article, we introduce various types of proximal interphalangeal joint fracture/dislocations and individualized surgical approach using hemihamate autograft and lag screw and/or hook plate as fixation methods.
Collapse
Affiliation(s)
- Jae-Woo Heo
- From the Department of Plastic and Reconstructive Surgery
| | - Jong Ick Whang
- From the Department of Plastic and Reconstructive Surgery
| | - Hyun Sik Park
- Department of Orthopedic Surgery, Institute of Hand and Microsurgery, Duson Hospital, Ansan, Republic of Korea
| |
Collapse
|
3
|
Hara T, Kurahashi T, Kuwahara Y, Tatebe M, Oguchi T, Urata S. The Results of Hook Plate Fixation for Palmar Fracture Dislocation of the Proximal Interphalangeal Joint. J Hand Surg Am 2023:S0363-5023(23)00496-3. [PMID: 37906242 DOI: 10.1016/j.jhsa.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/30/2023] [Accepted: 09/13/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE This study aimed to present the clinical outcomes of the dorsal plating technique for palmar fracture dislocations of the proximal interphalangeal (PIP) joint. This plating technique minimizes dissection and interference with the finger extensor mechanism. METHODS We treated seven patients (with a mean age of 39.1 years) with dorsal hook plates for palmar fracture dislocations of the PIP joint between April 2018 and August 2022. The little finger was affected in five patients, and ring finger was affected in two. The mean time to surgery was 5.6 days, and the postoperative follow-up period was seven months. On the second postoperative day, all patients were allowed active motion of both the PIP and the distal interphalangeal (DIP) joints. Simultaneously, DIP blocking exercises were started to prevent adhesion of the extensor mechanism. RESULTS The mean active flexion and extension of the PIP joint was 105° and -4°, respectively, whereas those of the DIP joint were 65° and 4°. No patient experienced extension lag in the DIP joint. The mean total active motion (TAM) was 273°, and the %TAM was 96%. The grip strength of the affected hand averaged 90% of that of the unaffected hand. The mean numerical rating scale for pain was 0.3 points, and the mean Hand20 score was 5.1 points. No complications were observed; two patients underwent implant removal at their request. CONCLUSIONS The present study suggests that this hook plate technique, which minimizes interference with the finger extension mechanism, is an effective surgical procedure that allows patients to tolerate early range of motion exercises and obtain satisfactory clinical outcomes in both the PIP and DIP joints. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic V.
Collapse
Affiliation(s)
- Tatsuya Hara
- Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan.
| | | | - Yutaro Kuwahara
- Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan
| | - Masahiro Tatebe
- Department of Hand Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takeshi Oguchi
- Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan
| | - Shrio Urata
- Department of Orthopaedic Surgery, Anjo Kosei Hospital, Anjo, Japan
| |
Collapse
|
4
|
Gu H, Zhu S, Li T, Wu X. Combination of Cable Cerclage and Hook Plate for the Fixation of Comminuted Fractures of Inferior Patellar Pole: A Review of 16 Consecutive Patients Followed Up for a Minimum of 1 Year. Orthop Surg 2022; 14:3111-3118. [PMID: 36208008 PMCID: PMC9627067 DOI: 10.1111/os.13481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 08/05/2022] [Accepted: 08/09/2022] [Indexed: 12/01/2022] Open
Abstract
Objectives To present a new method consisting of cable cerclage and hook plate for fixating the comminuted inferior patellar pole fracture and evaluate the outcomes. Methods A total of 16 consecutive patients who were treated with the construct of a cable cerclage in combination with a hook plate between January 2018 and September 2020 were included in the study. Mechanism of injury, duration, and technical details of the operation were reviewed. Plain radiographs and computerized tomography (CT) scans were routinely taken to evaluate the fracture pattern. The primary outcome measures included bony healing time, pain intensity‐numerical rating scale (PI‐NRS), range of motion (ROM), and the Bostman score at the final follow‐up. Results Eight males and eight females with an average age of 55.6 ± 12.0 years (range, 41 to 73 years) were included. Bony union was achieved in all the patients, with an average healing time of 10.8 ± 2.4 weeks (range, 8–16 weeks). With the average follow‐up of 20.1 ± 5.3 months, 12 patients (75%) had no pain (PI‐NRS score of 0), and the remaining four patients (25%) reported mild pain (three with a PI‐NRS score of 1 and one with a score of 2). The final Bostman score was 27.8 ± 3.0 (range, 20–30) on average, and all the patients showed excellent or good results. The average range of motion was 127.5° ± 13.9° (range, 90°–140°). No implant failure or hardware irritation was found during the follow‐up. Conclusion The fixation of cable cerclage combined with hook plate resulted as a reliable method for managing the inferior patellar pole fractures, allowing immediate rehabilitation and weight‐bearing.
Collapse
Affiliation(s)
- Hangyu Gu
- Department of Traumatology and Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China
| | - Shiwen Zhu
- Department of Traumatology and Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China
| | - Ting Li
- Department of Traumatology and Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China
| | - Xinbao Wu
- Department of Traumatology and Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China
| |
Collapse
|
5
|
Atiyya AN, Nabil A, Soliman R, Eldiasty A, Koriem I. Blocking Plate for Volar Proximal Interphalangeal Joint Fracture Dislocation. J Hand Surg Am 2022; 47:899.e1-899.e6. [PMID: 34538670 DOI: 10.1016/j.jhsa.2021.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 05/20/2021] [Accepted: 07/28/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE To assess the use of a 2-mm miniplate as a dorsal blocking plate to stabilize the central avulsion fragment in a proximal interphalangeal joint (PIP) volar fracture dislocation. METHODS This was a case series comprising 8 patients with volar fracture dislocation of the PIP joint. The average age of the patients was 36 years. The patients were managed by this technique within an average of 11 days following the injury. The clinical outcome measurements included the assessment of pain and range of motion of the PIP and distal interphalangeal joints. RESULTS The average follow-up duration was 20 months. The mean visual analog scale pain score was 1.9. The average range of motion of the PIP joint was 82°, whereas the average range of motion of the distal interphalangeal joint was 43°. Reduction of the subluxation was achieved in all cases, with no articular step remaining. CONCLUSIONS A dorsal blocking plate is a simple technique, associated with a satisfactory outcome, for volar fracture dislocation injuries of the PIP joint. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic V.
Collapse
Affiliation(s)
| | - Amr Nabil
- Orthopedic Department, Ain Shams University, Cairo, Egypt
| | - Ramy Soliman
- Orthopedic Department, Ain Shams University, Cairo, Egypt
| | | | - Islam Koriem
- Orthopedic Department, Ain Shams University, Cairo, Egypt.
| |
Collapse
|
6
|
Kastenberger T, Kaiser P, Benedikt S, Stock K, Eigl M, Schmidle G, Arora R. Surgical treatment of the bony mallet thumb: a case series and literature review. Arch Orthop Trauma Surg 2022; 142:887-900. [PMID: 35032189 PMCID: PMC8994723 DOI: 10.1007/s00402-021-04333-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/25/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The aim of this study was to provide a more precise statement on the outcome after surgical treatment of a bony mallet thumb and possibly give a treatment recommendation regarding the surgical fixation method. PATIENTS AND METHODS All patients (n = 16) who underwent a surgical treatment for an acute bony mallet thumb fracture between January 2006 and July 2019 were enrolled. The surgical method, complications, the range of motion, tip pinch, lateral key pinch, overall grip strength, visual analog score, Disability of the Arm, Shoulder and Hand Score, Mayo Wrist Score, Patient-Rated Wrist Evaluation Score, Buck-Gramcko Score and radiologic parameters were evaluated. Further, a comprehensive literature search on PubMed was conducted covering a period from 1956 to 2021 to include all possible matching articles on the treatment of the bony mallet thumb (n = 21 articles). RESULTS Surgical treatment was very inhomogenous including indirect and direct K-wire fixation, screw fixation, plate fixation and anchor fixation methods. The IP joint range of motion and thumb strength ranged from 66 to 94% in comparison to the contralateral side. An open reduction led to worse functional scores compared to a closed reduction. Treatment methods in the literature were also very inhomogenous with a very low patient count, often even pooling data of bony mallet thumb fractures with bony mallet finger fractures. The risk for infection was higher in K-wire fixation methods than in open reduction and internal fixation methods. CONCLUSION The evidence for the best treatment of a bony mallet thumb fracture is low. On one hand the functional outcome can be inferior using an open reduction approach, but on the other hand, K-wire fixation methods with a closed reduction approach showed a higher risk for infection. Future multi-center research must be conducted to find the best treatment procedure for the best outcome of the patient.
Collapse
Affiliation(s)
- Tobias Kastenberger
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Peter Kaiser
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Stefan Benedikt
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Kerstin Stock
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Magdalena Eigl
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Gernot Schmidle
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Rohit Arora
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
| |
Collapse
|
7
|
Orman O, Baydar M, İpteç M, Keskinbıçkı MV, Akdeniz HE, Öztürk K. A new custom-made plate preparation method for bony mallet finger treatment and a comparison with extension block technique. Jt Dis Relat Surg 2021; 32:617-624. [PMID: 34842093 PMCID: PMC8650668 DOI: 10.52312/jdrs.2021.156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 05/27/2021] [Indexed: 11/14/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Osman Orman
- İstanbul Metin Sabancı Baltalimanı Kemik Hastalıkları Eğitim ve Araştırma Hastanesi, El Cerrahisi Kliniği, 3447 Sarıyer, İstanbul, Türkiye.
| | | | | | | | | | | |
Collapse
|
8
|
Wang WC, Hsu CE, Yeh CW, Ho TY, Chiu YC. Functional outcomes and complications of hook plate for bony mallet finger: a retrospective case series study. BMC Musculoskelet Disord 2021; 22:281. [PMID: 33726740 PMCID: PMC7968289 DOI: 10.1186/s12891-021-04163-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background The treatment of mallet fracture using hook plate fixation was first introduced in 2007 and has subsequently shown excellent outcomes. Common complications, such as nail deformity and screw loosening, have also been reported. Very few studies have focused on these common complications or their prevention. In this study, we present the clinical outcomes and complications of our case series and describe the pitfalls and detailed solution of surgical tips to avoid common complications related to this procedure. Methods The retrospective case series of 16 patients with mallet fractures who underwent open reduction and hook plate fixation in our hospital from 2015 to 2020 were retrospectively reviewed. Data on extension lag, range-of-motion (ROM) of the distal interphalangeal joint (DIP) joint, the Disabilities of the Arm, Shoulder, and Hand (DASH) score, and surgical complications were collected and analysed. The clinical outcome was graded according to the Crawford mallet finger criteria. Results Sixteen patients were included in our analysis. The median DIP extension lag was 0° (range, 0° to 30°) and the median active DIP flexion angle was 60° (range, 40° to 90°). The median DASH score was 0 (range, 0–11.3). Fourteen patients with good and excellent results were satisfied with this treatment. The Complication rate in our patient series was 18%. Common complications reported in articles included wound necrosis, extension lag, nail deformity, and plate loosening. Conclusions Despite the fact that the treatment of mallet fracture with hook plate fixation has satisfactory functional outcomes, pitfalls, including iatrogenic nail germinal matrix injury, unnecessary soft tissue dissection, and insufficient screw purchase, were still reported. To avoid complications, we suggest modifications of the skin incision, soft tissue dissection, and screw position.
Collapse
Affiliation(s)
- Wei-Chih Wang
- School of Medicine, China Medical University, Taichung, Taiwan.,Department of Orthopedic Surgery, China Medical University Hospital, No. 2, Yude Road, North District, Taichung City, Taiwan, 404472, Taichung, Taiwan
| | - Cheng-En Hsu
- Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.,Sports Recreation and Health Management Continuing Studies-Bachelor's Degree Completion Program, Tunghai University, Taichung, 407, Taiwan
| | - Chen-Wei Yeh
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Tsung-Yu Ho
- Department of Orthopedic Surgery, China Medical University Hospital, No. 2, Yude Road, North District, Taichung City, Taiwan, 404472, Taichung, Taiwan
| | - Yung-Cheng Chiu
- School of Medicine, China Medical University, Taichung, Taiwan. .,Department of Orthopedic Surgery, China Medical University Hospital, No. 2, Yude Road, North District, Taichung City, Taiwan, 404472, Taichung, Taiwan.
| |
Collapse
|
9
|
Lee JI, Park KC, So HS, Lee DH. Clinical outcomes after mini-hook plate fixation for small avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand. J Orthop Surg Res 2021; 16:186. [PMID: 33706801 PMCID: PMC7953753 DOI: 10.1186/s13018-021-02339-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 03/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mini-hook plate has been described for the treatment of various small avulsion fragments in the hand. This retrospective study aimed to evaluate clinical outcomes after mini-hook plate fixation in patients with an avulsion fracture around the interphalangeal or metacarpophalangeal joints of the hand. METHODS Nineteen patients with avulsion fractures around the interphalangeal or metacarpophalangeal joints of the hand were included in this study. Seven patients had a mallet fracture, and 12 patients had other phalangeal avulsion fractures including central slip, collateral ligament, volar plate, and flexor avulsion fractures. The osseous union and functional outcomes, including finger joint motion, joint stability, pinching strength, and the disabilities of the arm, shoulder, and hand score, were evaluated. RESULTS The mean duration of follow-up was 33.8 months. All patients in mallet and other phalangeal avulsion fractures achieved osseous union between the avulsion fragment and phalangeal bone, and there was no joint subluxation. There were no significant differences in the disabilities of the arm, shoulder, and hand scores. However, the patients with mallet fracture have lower mean percentage values of the total active range of motion and pinching strength than other phalangeal avulsion fractures. We abandoned this procedure in mallet fractures because the early results after mini-hook plate fixation in mallet fractures appeared unfavorable. CONCLUSION These results suggest that the mini-hook plate fixation can provide sufficient stability and good clinical outcomes in those with phalangeal avulsion fractures. However, the outcomes for mallet fractures were not as good as those for other phalangeal avulsion fractures.
Collapse
Affiliation(s)
- Jung Il Lee
- Department of Orthopedic Surgery, Korea University Guro Hospital, Seoul, South Korea.
| | - Ki-Chul Park
- Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, South Korea
| | - Hyun Soo So
- Department of Orthopedic Surgery, Hanyang University Guri Hospital, Guri, South Korea
| | - Duk Hee Lee
- Department of Emergency Medicine, Ewha Women's University Mokdong Hospital, Seoul, South Korea
| |
Collapse
|
10
|
Mini hook plate fixation for thumb ulnar collateral ligament avulsion fracture: A technical report. Orthop Traumatol Surg Res 2019; 105:429-433. [PMID: 30922808 DOI: 10.1016/j.otsr.2019.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 11/27/2018] [Accepted: 01/08/2019] [Indexed: 02/02/2023]
Abstract
Ulnar collateral ligament (UCL) injuries of the thumb sometimes occur with avulsion fracture. Avulsion fractures generally require open reduction and internal fixation to restore stability of the metacarpophalangeal (MP) joint of the thumb. Although several surgical techniques have been reported, UCL avulsion fractures are still challenging hand injuries to treat and to obtain stable fixation that allows early finger motion because of small size of fragment. This report describes two cases of thumb UCL avulsion fractures that were successfully treated with two-hole mini hook plates by adapting 1.5-mm variable angle locking hand plates. This method allowed for early postoperative rehabilitation and provided stability of the thumb MP joint and satisfactory clinical outcomes. Altogether, hook plate fixation could be an alternative technique for thumb UCL avulsion fracture.
Collapse
|