Outcome of Hook Plate Fixation of Mallet Fractures

Hook plate fixation of closed mallet fractures was first described in 2007, but there has subsequently been a lack of studies examining the outcomes and complications of this technique.

This paper aims to assess the clinical outcomes of hook plate fixation of closed mallet fractures by retrospectively reviewing 31 closed, bony mallet injuries that were surgically fixed with a hook plate between 2002-2011.

Patients who underwent hook plate fixation had a median time to radiographic union of 83 days. Pre-operative median distal interphalangeal joint (DIPJ) extensor lag was 20°, with a post-operative extensor lag of 0°. Median DIPJ flexion was 60°, with 58% of all cases achieving greater than 50° of DIPJ flexion. There were 4 instances of minor complications (i.e. transient nail deformity and marginal skin flap ischaemia), with 3 cases of major complications (i.e. fracture redisplacement).

Our results show that the hook plate technique has satisfactory functional outcomes and an acceptable complications rate compared to other treatment modalities in the existing literature. Nevertheless, the outcomes of this technique in our sample population were not as excellent as initially reported.

Level IV: Retrospective case series, Therapeutic Studies.