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Less-Invasive Technique for Non-stabilized Mandibular Fracture in Mouse Models
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Unstable mallet fractures: a comparison between three different techniques in a multicenter study.

Stefano Lucchina1, Alejandro Badia, Vlad Dornean

  • 1Surgical Department-Hand Surgery Unit, Locarno's Regional Hospital, Locarno, Switzerland. stefano.lucchina@handregistry.com

Chinese Journal of Traumatology = Zhonghua Chuang Shang Za Zhi
|July 31, 2010
PubMed
Summary

This study compared three surgical techniques for mallet fractures. All methods achieved bone union, with no significant differences in functional outcomes, though ORIF allowed faster return to work.

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Published on: April 11, 2012

Area of Science:

  • Orthopedic surgery
  • Hand surgery
  • Traumatology

Background:

  • Mallet fractures, particularly those involving over 1/3 of the articular surface with palmar subluxation, present management challenges.
  • Surgical intervention is often considered for complex mallet fractures.

Purpose of the Study:

  • To retrospectively compare the efficacy of three surgical techniques for treating mallet fractures with palmar subluxation.
  • Evaluate Kirschner wire fixation with extension block pinning (EBP), Kirschner wires as joysticks (KWJ), and open reduction and internal fixation (ORIF) using mini-screws.

Main Methods:

  • A retrospective analysis of 58 patients with mallet fractures treated with EBP (20 patients), KWJ (16 patients), or ORIF (22 patients).
  • Parameters assessed included intraoperative time, hardware used, technical issues, work absence, complications, radiological bone union, and functional range of motion (ROM) using the Crawford score.

Main Results:

  • All 58 fractures achieved bone union without signs of osteoarthritis.
  • KWJ technique showed shorter intraoperative time and wider total ROM compared to ORIF and EBP.
  • ORIF resulted in a faster return to work (2.7 weeks) but had a higher complication rate due to screw positioning.

Conclusions:

  • All three surgical techniques (EBP, KWJ, ORIF) are effective for mallet fractures, leading to bone consolidation and good functional outcomes.
  • ORIF offers faster return to work but is technically more demanding; EBP and KWJ are quicker with fewer complications but require careful pin tract management.
  • No statistically significant differences were observed in overall functional results (ROM, extension lag, Crawford score) among the three techniques.