TechniquesOpen Reduction Internal Fixation of the Unstable Mallet FracturePhadnis, Joideep MBChB, MRCS; Yousaf, Sohail MBBS, MRCS; Little, Nicholas MBBS, FRCS (orth); Chidambaram, Ramiah MBBS, FRCS (orth); Mok, Daniel MBBS, FRCS (orth)Author Information Epsom Hospital NHS Trust, Surrey, United Kingdom Declaration of Conflicting Interests/Funding: All named authors hereby declare that they have no conflicts of interest to disclose. No funding was received as part of this study. Address correspondence and reprint requests to Joideep Phadnis, MBChB, MRCS, 15 Sandycombe Road, Richmond, Surrey, TW9 2EP, United Kingdom E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: September 2010 - Volume 14 - Issue 3 - p 155-159 doi: 10.1097/BTH.0b013e3181d13800 Buy Metrics Abstract Unstable mallet fractures of the digit pose a challenge when treated surgically. We present the results of a technique, not earlier described, for the fixation of these uncommon injuries. The technique involves anatomical reduction and stable fixation of the distal articular fragment combined with stabilization of the distal interphalangeal joint with buried Kirschner wires allowing early mobilization of the digit. Twenty patients with an average follow-up of 12.7 months (10 mo to 21 mo) are presented. Results were good/excellent (Crawford's criteria) in 16 patients, fair in 3, and poor in 1 with those operated upon within 2 weeks postinjury achieving the best results. There were no incidences of fixation failure, loss of reduction, or posttraumatic osteoarthritis. One patient had a minor infection, but there were no cases of nail deformity or wound breakdown. There was high patient satisfaction and all patients returned to work after treatment. We conclude that this is a reliable technique with minimal complications and is comparable with other published operative and nonoperative treatment modalities. © 2010 Lippincott Williams & Wilkins, Inc.