Closed mallet thumb injury: Our experience of 10 patients treated with surgery and a systematic review

• Published in: Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2016-06, Vol.69 (6), p.835-842
• Main Authors: Abe, Yoshihiro, Rokkaku, Tomoyuki, Tokunaga, Susumu, Yamada, Toshiyuki, Okamoto, Seiji
• Format: Article
• Language: English
• Subjects: Adult; Closed mallet thumb; Comparative Effectiveness Research; Conservative treatment; Conservative Treatment - methods; Female; Finger Injuries - diagnosis; Finger Injuries - surgery; Finger Injuries - therapy; Fractures, Closed - diagnosis; Fractures, Closed - surgery; Fractures, Closed - therapy; Humans; Japan; Male; Mallet thumb; Middle Aged; Range of Motion, Articular; Reconstructive Surgical Procedures - methods; Retrospective Studies; Surgery; Suture Techniques; Systematic review; Thumb - injuries; Thumb - surgery; Time-to-Treatment; Treatment Outcome
• ISSN: 1748-6815; 1878-0539
• DOI: 10.1016/j.bjps.2016.03.002

This retrospective study reports 10 patients with closed mallet thumb injury treated with surgery and compares the clinical outcomes achieved with those of previously described patients who were treated with either conservative therapy or surgery. We report the outcomes of a series of 10 patients who received surgical treatment at our institutions. Due to the rarity of closed mallet thumb, a systematic review was conducted, and the results of a literature search were compared with our case series to strengthen our conclusions. The previously described patients were categorized into two groups: the surgically treated group (16 patients) and the conservatively treated group (10 patients). The following patient and injury characteristics were documented: age, gender, injured side, time from injury to treatment, mechanism of injury, extension lag at first visit, postoperative range of motion (ROM) of the interphalangeal joint, immobilization period, and follow-up period. Statistical analyses showed no significant differences in the clinical results, except for shorter immobilization periods between our series and the previously described patients involving conservative treatment (4.9 ± 0.9 vs. 9.5 ± 2.3 weeks, respectively; P = 0.0053). This study suggests that surgery may result in more rapid recovery.