Mallet fingers with bone avulsion and DIP joint subluxation

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Mallet finger injuries frequently include fractures, with one-third of cases associated with bone fragments.
• Large fracture fragments in mallet fractures can lead to volar subluxation of the distal phalanx.
• Current management strategies for mallet fractures are diverse, influenced by injury characteristics and surgeon preference.

Purpose of the Study:

• To review the varied management approaches for mallet fractures.
• To highlight the lack of consensus regarding operative treatment for mallet fractures.
• To assess the evidence supporting operative versus nonoperative management.

Main Methods:

• Review of existing literature on mallet fracture treatment.
• Analysis of different surgical techniques including splinting, closed reduction with percutaneous pinning, and open reduction with internal fixation.
• Evaluation of the evidence base for various treatment modalities.

Main Results:

• Management of mallet fractures encompasses splinting, closed reduction and percutaneous pinning, and open reduction and internal fixation.
• Despite described surgical techniques, a clear consensus on operative treatment is lacking.
• There is insufficient evidence to definitively support operative over nonoperative treatment for mallet fractures.

Conclusions:

• The optimal treatment for mallet fractures remains debated due to varied injury patterns and surgeon preferences.
• Further research is needed to establish evidence-based guidelines for mallet fracture management.
• The current evidence does not strongly favor surgical intervention for mallet fractures over conservative approaches.