What is the role of fracture in the etiology of mallet finger?

Updated: Aug 27, 2018
  • Author: Roy A Meals, MD; Chief Editor: Harris Gellman, MD  more...
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Mallet deformity can also be associated with a fracture of the dorsal articular surface of the distal phalanx. Radiographically, these bony avulsions can be characterized into three common patterns, as follows:

  • A tiny fleck of bone that involves less than 25% of the articular surface
  • A large bony fragment that involves 30% or more of the articular surface
  • An avulsion of any size that is associated with palmar subluxation of the distal phalanx

Generally, fleck fractures and nondisplaced avulsions that involve up to 40% of the joint surface are believed to be stable injuries. [4] Individuals with stable injuries are candidates for conservative treatment. (See the image below.)

Stable mallet fracture that involves 40% of the jo Stable mallet fracture that involves 40% of the joint surface.

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