What is the role of surgery in the treatment of mallet fingers or jersey fingers?

Updated: Jan 18, 2018
  • Author: Jay E Bowen, DO; Chief Editor: Craig C Young, MD  more...
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Mallet fingers involving fractures of more than 25-30% of the articular surface, or if volar subluxation of the DIP joint is present, then open reduction and internal fixation is indicated. Fixation is continued for 4-6 weeks, after which the pins are removed and motion is begun. The patient wears an external splint for the month after internal fixation is discontinued.

For jersey fingers, with continued extension vector force, the distal phalanx continues into hyperextension. Subsequently, a secondary intra-articular fracture at the base of the distal phalanx occurs as the distal portion of the middle phalanx is driven into the base of the distal phalanx. Avulsion of the flexor digitorum profundus with a separate intra-articular fracture of the distal phalanx has been proposed as a type 4 injury. Treatment consists of open reduction and internal fixation of the intra-articular fracture with reinsertion of the profundus tendon.

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