Although there are various methods of operative treatment for hony mallet finger, the operative technique is not so easy and complications such as joint stiffness, sott tissue prohlems, infection, change of nail shape and arthrosis are common. The authors performed operations for 26 cases of hony mallet fingers, fixing the hony frapment by Kirschner wire, pull-out wire suture and miniscrew respectively, from Jan. l988 to Jun. l996. The results were as follows. l. According to Niechajev's classification. there were 3 cases of type B, 7 cases of type C, l4 cases of type D, and 2 cases of type E. And 11 cases were accompanied hy crushing injury. 2. Involved fingers were third finger in 11cases, fit'th finger in 7 cases, fourth finger in 5 cases, second finger in 2 cases. and thumb in I case. 3. The hony mallet finger was caused hy occupational injury in l6 cases, direct blow in 7 cases and sports injury in 3 cases. 4. The fractured fragment was fixed hy Kirschner wire in 9 cases, by pull-out suture in 9 cases and by miniscrew in 8 cases. 5. The results were evaluated hy Kanies scale. Sixteen cases had satisfactory results. Seven cases (87.5%) were satisfactory in miniscrew fixations. 5 cascs (55.6%) in pull-out wire suture methocls and 2 cases (22.2%) in Kirschner wire tixations. 6. The complications were joint incongruity in 4 cases, dorsal prominece in 6 cases, painful limitation of motion in 2 cases which were treated by arthrodesis, pin site infection in 2 cases and hreakage of wire suture in 1 case. 7. The miniscrew fixation offered relatively firm fixation, low complication rate, and good results. so it can be considered as one of the good methods of treatment for hony mallet finger.
Arthrodesis ; Athletic Injuries ; Classification ; Fingers* ; Joints ; Occupational Injuries ; Sutures ; Thumb

Humans ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Thumb ; abnormalities ; surgery

This case report describes the use of a Functional Thenar Eminence myocutaneous flap for reconstruction of volar defect of distal right thumb of a 25-year-old male who sustained a twisting injury while working. Part of bone and tendon were exposed and the tip of the distal phalanx was crushed, with bony defect.
Adult ; Humans ; Male ; Myocutaneous Flap ; Thumb ; injuries ; surgery

The hand consists of five sesamoids. Two of them are present at the metacarpophalangeal (MCP) joint of the thumb. Fracture of the sesamoid bones of the thumb is a rare injury and the literature on the radial side is seldom reported. We reported a case of a patient with a fracture of the radial sesamoid at the MCP joint of the thumb in order to increase attention regarding this type of injuries. A 44-year-old male, high level gymnastic trainer, was helping one of his athletes during an exercise while he reported a hyperextension trauma to the MCP joint of the right thumb. One week after trauma, he presented to the hand surgeon complaining of a painful thumb at the MCP joint level on its palmar aspect. Standard A-P and lateral X-rays revealed a fracture of the radial sesamoid and the fracture was treated with a splint for 3 weeks. He was able to resumed his entire work 6 weeks after the injury. The sesamoid fractures is an indicator of the magnitude of the hyperextension injury and sometimes associated with tears of the volar plate ligament of the MCP joint. And a failure to recognize the ligament injury may lead to a long-term hyperextension instability on pinching.
Fractures, Bone ; diagnostic imaging ; Humans ; Metacarpophalangeal Joint ; injuries ; Radiography ; Sesamoid Bones ; Thumb ; injuries

The old flexor tendon injury in the hand seen after 4 weeks from damage and associated with crushing injury, heavy scarring, fracture and infectious state has the difficulty to deliver the flexor tendon through fibro-osseous sheath and the pulleys. Treatment method depends on the circumstances of the injured flexor tendon and surgeons' judgement. We have treated twenty-three fingers of twenty-three cases, who had old flexor tendon injury, by advancement and tenolysis in 1 each, tendon graft in 5, and staged tendon graft in 16 from March 1989 through February 1994. The result was summarized as follows. 1. The old flexor tendon injury most commonly occurred in the fifth finger(11 cases, 47.8%)and in zone II (16 cases, 69.6%). 2. The most common cause was glass injury(15 cases, 69.6%). 3. 21 of 23 cases(2 thumbs excepted)were evaluated according to the original Strickland system. 14 cases of the staged tendon graft showed excellent(6 cases, 42.9%), good(5 cases, 35.7%)and fair(3 cases, 21.4%). 5 cases of the tendon graft showed excellent(2 cases, 40%), good(1 case, 20%), and fair(2 cases, 40%). 1 case of adhesiolysis and 1 case of advancement showed excellent and good results each. Little difference is observed in the method between the staged graft and tendon graft. 4. The degree of the associated soft tissue injury should be evaluated by the experienced hand surgeon before surgery and the delicate balance between protection and mobilization during the postoperative weeks is important as well as the surgical skill.
Cicatrix ; Fingers ; Glass ; Hand ; Methods ; Soft Tissue Injuries ; Tendon Injuries ; Tendons ; Thumb ; Transplants

OBJECTIVES: To study the injury manners of Bennett fracture and Rolando fracture and explore its identification principle of the first metacarpal base fractures. METHODS: Totally 31 cases of Bennett fracture and Rolando fracture were collected. The injury manners of cases of 19 Bennett fractures and 12 Rolando fracture were classified, and various injury manners were analysed statistically. RESULTS: The injury manners of the cases of 19 Bennett fracture and 12 Rolando fracture were divided into three types, including the first metacarpus hit hard objects during a punching, the first metacarpus hit hard objects when making fists and fell, or the first metacarpus was punched by hard objects when making fists. CONCLUSIONS The injury mechanism of Bennett fracture and Rolando fracture is formed by a force on the first metacarpus when making fists, which transmits to the basilar part along the vertical axis of metacarpus. The inference of injury manners should be focused on the confirmation of entrusted matters.
Epiphyses ; Fracture Fixation, Internal/methods* ; Fractures, Bone/surgery* ; Humans ; Joint Dislocations/surgery* ; Metacarpus/injuries* ; Thumb/injuries*

A traumatic carpometacarpal joint dislocation of the thumb accounts for less than 1% of all hand injuries. Optimal treatment strategies for this injury are still a subject of debate. In this article, we report a case of bilateral thumb carpometacarpal joint dislocations: a unique combination of injuries. We believe our case is the second report of bilateral carpometacarpal joint dislocation regarding the thumb in English literature. It was successfully treated with closed reduction and percutaneous K-wires fixation on one side, and an open reduction and reconstruction of the ligament on the other side.
Bone Wires ; Carpometacarpal Joints/*injuries/*surgery ; Dislocations/*surgery ; Hand Injuries/*surgery ; Humans ; Male ; Middle Aged ; Thumb/*injuries/*surgery

Double fracture-dislocations of the thumb are rare. Only a single case report of a simultaneous extra- articular fracture of the base of the first metacarpal and dislocation of the metacarpophalangeal joint has been previously reported. We report the second case report of this injury in a 20-year-old man. The patient had an excellent outcome after treatment.
Adult ; Fractures, Bone ; surgery ; Humans ; Joint Dislocations ; surgery ; Male ; Metacarpal Bones ; injuries ; Metacarpophalangeal Joint ; injuries ; Thumb ; injuries

PURPOSE: To compare the clinical results of spontaneous rupture of extensor pollicis longus tendon treated by palmaris longus tendon graft (group I) versus extensor indicis proprius tendon transfer (group II). MATERIALS AND METHODS: Out of twenty-five patients who suffer from spontaneous extensor pollicis longus tendon rupture, twelve patients were treated by palmaris longus tendon graft and thirteen patients were treated by extensor indicis proprius tendon transfer. Postoperatively thumbs were immobilized with thumb spica splint for three weeks. Active and passive movement was allowed subsequently for six weeks. The functions of the thumbs were assessed by the Geldmacher criteria and statistically compared. RESULTS: The overall outcome was excellent in 5(20%) of patients and good in 17(68%) of patients and satisfactory in 3(12%) of patients. The mean scores using the Geldmacher criteria were 18.50 for palmaris longus tendon graft and 19.69 for extensor indicis proprius tendon transfer. No significant difference was noted between two groups. CONCLUSION: Both methods establish equally good clinical results in patient with chronic extensor pollicis longus tendon rupture. Extensor indicis proprius tendon transfer seems more available methods.
Humans ; Rupture ; Rupture, Spontaneous ; Splints ; Tendon Injuries ; Tendon Transfer ; Tendons ; Thumb ; Transplants

To analyze and compare with survival rate of replantation according to each finger and distal interphalangeal joint, we reviewed 230 digital replantation of proximal or distal to the distal interphalangeal joint in 170 patients. From July 1996 to March 1998, 230 digits in 170 patients with complete or incomplete amputations in the proximal or distal to the distal interphalangeal joint were replanted using a microsurgical technique at Jung-ang Gil Medical Center, Gachon Medical School. We classified the finger amputations according to distal interphalangeal joint. As reference line, that is, proximal and distal to DIP joint though many classifications had been proposed. The overall survival rate was 71%, with the survival rates for proximal were 69%, 70%, 65%, 89%, 76%, in order from thumb to little finger and that for distal being 63%, 74%, 59%, 82%, 67%,respectively. The survival rates for proximal replantation were higher than in distal replantation of all digits except index finger, and that was higher in incomplete type injury(76%) than in complete(67%). But there was no statistically significant difference in survival rates for proximal or distal level. Although the technique of tinger replantation was difficult, it was worth attempting to try replantation in any level of amputation because of superiority in the aesthetic and functional result.
Amputation ; Classification ; Fingers* ; Hand Injuries* ; Hand* ; Humans ; Joints* ; Replantation* ; Schools, Medical ; Survival Rate* ; Thumb