Albahlal Jarallah M, Alzahrani Abdullah, Khan Hayat
Orthopedic Surgery, Dr. Sulaiman Alhabib Medical Group, Riyadh, SAU.
Cureus. 2023 Aug 31;15(8):e44441. doi: 10.7759/cureus.44441. eCollection 2023 Aug.
Bony mallet finger injuries, commonly seen as isolated incidents, typically occur in active individuals. We report a rare case of simultaneous avulsion fractures at the distal phalangeal bases of the second, third, and fourth fingers on the right hand of a 14-year-old boy following a forced passive flexion injury during a football game. The patient initially received conservative management with a finger extension splint for the distal interphalangeal (DIP) joints. However, one week after the injury, we performed surgical fixation on all affected digits using the K-wire extension block method due to multiple fractures and the patient's intolerance for the mallet finger splint. After six weeks, all K-wires were removed, and physiotherapy sessions began. Three months post-injury, the second and fourth DIP joints demonstrated an "Excellent" outcome, and the third DIP joint demonstrated a "Good" outcome based on Crawford's criteria for outcome assessment of mallet finger injury after management. This case highlights the importance of early detection and appropriate management of concomitant mallet finger injuries in pediatric patients to prevent potential complications that could impair hand function and quality of life.
锤状指骨折损伤通常为孤立事件,常见于活跃人群。我们报告了一例罕见病例,一名14岁男孩在一场足球比赛中因被动强制屈曲受伤,导致右手第二、三、四指远节指骨基底部同时发生撕脱骨折。患者最初接受了保守治疗,使用手指伸展夹板固定远侧指间(DIP)关节。然而,受伤一周后,由于多处骨折且患者无法耐受锤状指夹板,我们对所有受影响手指采用克氏针延长阻滞法进行了手术固定。六周后,所有克氏针均被取出,并开始进行物理治疗。根据克劳福德锤状指损伤治疗后结果评估标准,受伤三个月后,第二和第四DIP关节显示“优秀”结果,第三DIP关节显示“良好”结果。该病例强调了早期发现和适当处理儿童患者并发锤状指损伤的重要性,以预防可能损害手部功能和生活质量的潜在并发症。