A new custom-made plate preparation method for bonymallet finger treatment and a comparison with extensionblock technique

Abstract

Objectives: In this study, we aimed to describe a new hookplate technique (HPT) and to compare our results with theconventional extension block technique (EBT) with a Kirschnerwire (K-wire) for bony mallet finger treatment. Patients and methods: Between April 2015 and January2018, a total of 19 patients including 10 who were treatedwith EBT (7 males, 3 females; mean age: 30.1±7.3 years;range, 17 to 48 years) and nine who were treated withHPT (6 males, 3 females; mean age: 31.7±11.3 years;range, 19 to 42 years) for bony mallet finger with distalinterphalangeal (DIP) joint subluxation and/or fracture fragmentlarger than one-third of distal phalanx (Wehbe-Schneider type1/b, 2/a, 2/b, 3/a) joint were retrospectively analyzed. The DIPrange of motion (ROM), Warren and Crawford scores, time toreturn to work/daily activity, operation time, the number offluoroscopy shots, cost and complications were compared. Results: No significant difference was found in the DIP ROM(p=0.708) and the Warren/Norris and Crawford scores (p=0.217and p=0.175, respectively) between the two groups. Operationtime and material cost were higher with HPT (p=0.006, p=0.001).There was no significant difference in the number of fluoroscopyshots (p=0.344). Although DIP joint motion was started at twoweeks in the HPT group and at eight weeks in the EBT group, nosignificant difference was observed in the time of return to workand normal daily life in both groups (p=0.859). Complicationswere observed in two patients in the EBT group and in threepatients in the HPT group. No significant difference in totalcomplications was observed between the two groups (p=0.666). Conclusion: Bony mallet finger treatment with a custom-madehook plate prepared from 1.3-mm AO plates appeared to beclinically and radiologically similar to EBT. Additionally, HPThad the advantages of allowing early ROM to DIP joint andeliminating the need for a secondary surgery such as K-wireremoval. On the other hand, hardware cost with HPT was higherthan EBT.