Mallet fractures.

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Abstract
In a review of 160 mallet fingers, 44 were found to have a fracture of the distal phalanx. Of these mallet fractures, 21 could be followed for a mean of 3.25 yr (range, 6 mo.-8 yr). Six were treated surgically and 15 had simply been splinted. Of these 21 mallet fractures, all but 1 had a good result irrespective of the form of treatment. Bone-remodeling occurred in all digits (including 2 with fibrous union), with reconstitution of the articular surface and preservation of the joint space as seen on radiographs. There was also a near-normal range of painless motion in all but 1 finger. Poor patient compliance was an occasional difficulty when conservative treatment was used. Surgical treatment was difficult and unreliable; it offered no advantage over conservative treatment and had a greater rate of morbidity. The major complication of both forms of treatment was a bone prominence on the dorsum of the distal interphalangeal joint. Most mallet fractures can be treated conservatively, ignoring joint subluxation and the size and amount of displacement of the bone fragment.

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