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Surgical Treatment of Chronic Mallet Finger

Makhlouf, Vincent M. MD; Deek, Nidal Al MD

doi: 10.1097/SAP.0b013e3181e6d017
Review Article

The literature to find the best approach to correct a chronic mallet finger deformity has been reviewed. All the evidence we found was type IV mallet finger injury, based on the CEBM classification. In the European literature, if correction of the proximal interphalangeal joint is not needed, and surgery is to be done on the distal interphalangeal joint only, then the most frequently reported technique involves the conversion of the chronic injury into an acute one by excising the scar and part of the joint capsule, and the extensor tendon is reattached with minor variations. An 80% to 100% success rate can be expected. In the US literature, the Fowler release is favored, but it does not reliably correct a flexion deformity of more than 35 degrees. Spiral retinacular reconstruction provides an excellent solution if the associated swan neck deformity needs to be corrected.

From the Division of Plastic Surgery, University of Illinois, Chicago, IL.

Received January 17, 2010, and accepted for publication (after revision) May 7, 2010.

Reprints: Vincent M. Makhlouf, MD, Division of Plastic Surgery, University of Illinois at Chicago, 820 S Wood, 515 CSN, Chicago, IL 60612. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.