gms | German Medical Science

Objectives/Interrogation: Mallet fractures are common injuries in the finger, but refracture of post-operative mallet fracture is rare. Traditionally, surgeons recommended surgery for injuries involving more than one-third of the DIP joint articular surface and those with subluxation or displacement. If the patients who have mallet fracture involving more than one-third of the DIP joint articular surface don't want to choose the operative treatment, only the conservative treatment should be chosen. We reported the conservative treatment for two rare cases of refracture of post-operative mallet fracture in childhood.

Methods: Case 1: 13 y/o female injured her left ring finger during balleyball. 4 days after injury, closed pinning (Ishiguro method) was performed. X-ray showed good bone heeling after 5 weeks, k-wires were removed and she started finger exercise. 3 months after operation, she injured same finger during balleyball. This time she refused the operative treatment, conservative treatment was started.

Case 2: 13 y/o female injured her right index finger during basketball. 5 days after injury, closed pinning (Ishiguro method) was performed. X-ray showed good bone heeling after 5 weeks, k-wires were removed and she started finger exercise. 4 months after operation, she injured same finger during basketball. As the mallet bone fragment was little bit small comperared to case 1, so conservative treatment was chosen.

X-ray and ROM of injured DIP joint asssement were done.

Milford criteria was used for clinical assesment.

Results and Conclusions: X-ray showed bone union at 4 months period for two cases. Each case of the ROM of DIP joint was almost full. Clinical assesments by Milford criteria were excellent in case 1, and good in case 2. But case 1 showed swan-neck deformity slightly. Conservative treatment for mallet refracture took 4 months period for bone union and showed almost good clinical results, if the DIP joint subluxation was not exist.