Two Different Techniques In Treatment Of "Mallet Finger" Injury
Tomislav Jovanoski, MD, Sofija B Pejkova, MD, PhD, Bisera Nikolovska, MD, Igor Peev, MD, PhD, Gordana Georgieva, MD and Blagoja Srbov, MD, University Clinic for Plastic and Reconstructive Surgery, Medical Faculty, University "St.Cyril and Methodius", Skopje, Macedonia, The former Yugoslav Republic of
Introduction: Flexion deformity of the finger at DIP (distal interphalangeal) joint or Mallet finger is a condition caused by the disruption of the extensor tendon apparatus at the joint alone or combined with fracture of the distal phalanx. The aim of this study is to compare functional results after treatment of mallet finger injuries using open or closed technique.
Materials and Methods: For the aim of this study we have retrospectively analyzed 36 patients treated at University Clinic for plastic and reconstructive surgery in the period from January 2015 till December 2018. All patients were selected according precisely defined criteria for inclusion in the study. Patients were divided in two groups, Group A (20 patients), where open tenorrhaphy was performed and Group B (16 patients), where percutaneous tenorrhaphy was treatment of choice. Age, sex, type of injury, dominant or non-dominant hand, type of treatment, complications were recorded for every patient. Patients were followed-up weekly, 1, 3, 6, 9 and 12 months after treatment. The functional outcome after the treatment of the injury was assessed using the Crawford criteria.
Results: According the Crawford criteria an excellent outcome was found in 12 from Group A and 11 from Group B, good outcome was found in 8 from Group A and 5 from Group B. There was only 1 fair outcome in patient from Group B and no poor outcome at all. Our results showed that there were only excellent and good outcomes with average of 3,5 ± 0,5 degrees extension deficit in patients that had open tenorrhaphy and also excellent and good outcomes with one fair outcome in patients with percutaneous tenorrhaphy with average of 3,2 ± 0,8 degrees extension deficit. The results of our study have shown that there is no statistical difference in the final outcome between these two operative techniques.
Conclusion: Mallet finger is more frequent in males and the dominant hand. Skin complications such as partial epidermolysis, are more common in patients with open tenorrhaphy. Final outcome was not affected in any point, therefore we can conclude that open or percutaneous tenorrhaphy treatment of the open mallet finger injury can be used as a method of treatment, without different clinical outcome.
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