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2014 ; 9
(4
): 499-503
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The Meniscus Arrow® as a fixation device for the treatment of mallet fractures:
results of 50 cases
#MMPMID25414612
Aarts FL
; Derks R
; Wouters DB
Hand (N Y)
2014[Dec]; 9
(4
): 499-503
PMID25414612
show ga
BACKGROUND: The treatment of mallet fractures is a controversial and challenging
problem. Generally, mallet fractures are treated conservatively except those
involving more than one third of the base of the distal phalanx. Many different
surgical fixation techniques have been published. This paper describes a new
fixation procedure using ultimate bioresorbable meniscal fixation nails (Meniscus
Arrows®). METHODS: Mallet fractures in 50 digits of 49 patients were fixed with
this nail in an outpatient surgical procedure, mostly under local (Oberst-block)
anaesthesia. The average operation time was 21 min. RESULTS: According to the
Crawford criteria, patient outcome was graded as excellent in 48 %, good in 22 %,
and fair in 28 %. In one patient, the outcome was graded as poor, but the
fracture was in a pre-existent arthritic joint. All fractures were consolidated
without recurrent dislocation. Complications included one wound infection, which
was successfully treated with antibiotics and without further consequences. No
nail deformities occurred. Two times, the nail spontaneously and gradually
dislocated during intensive use of the hand after, respectively, 3 and 6 months
and could easily be removed under local anaesthesia without any functional
sequelae. CONCLUSION: The bioresorbable meniscal nail fixation technique provides
a fast and successful surgical treatment for mallet fractures with a minimum of
adverse events.