Universität zu Köln

Kreuder, Andrea, Pennig, Dietmar, Boese, Christoph Kolja, Eysel, Peer, Oppermann, Johannes and Dargel, Jens (2016). Mallet finger: a simulation and analysis of hyperflexion versus hyperextension injuries. Surg. Radiol. Anat., 38 (4). S. 403 - 408. PARIS: SPRINGER FRANCE. ISSN 1279-8517

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Abstract

The goal of this study was to simulate the mechanisms of hyperflexion and hyperextension injuries of the distal interphalangeal (DIP) joint of the hand and to analyze the resulting extensor tendon injury patterns. The hypotheses were raised that hyperflexion trauma leads to a plastic deformation of the extensor tendon aponeurosis, with or without a small bony avulsion fragment but without joint surface involvement, and that hyperextension injuries can create a shear fracture of the dorsal lip of the distal phalanx, without injury to the extensor tendon aponeurosis. Loading was applied with a swinging pendulum impacting the distal phalanx in 103 human specimens in either an extended or flexion position. After loading, injury patterns were analyzed radiologically and histologically. There was evidence that hyperflexion trauma leads to a plastic deformation or rupture of the extensor tendon. Bony tendon avulsion was evident in 12.2 % of cases. With hyperextension, the extensor tendon remained intact in all cases, but there were large fracture fragments involving the articular surface in 4.1 % of cases. The results of the study show that force on the flexed joint leads to overstretching of the extensor tendon, and to an associated dorsal bony avulsion with intact joint line. Force applied to the joint in extension can lead to a bony dorsal edge fracture with articular involvement and with it, a palmar DIP joint capsule rupture. The results illuminate a direct correlation between the mechanism of injury and the pattern of injury in the clinical picture of mallet finger.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kreuder, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Pennig, Dietmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Boese, Christoph Kolja UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, Peer UNSPECIFIED UNSPECIFIED UNSPECIFIED Oppermann, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Dargel, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-277314
DOI:	10.1007/s00276-015-1577-6
Journal or Publication Title:	Surg. Radiol. Anat.
Volume:	38
Number:	4
Page Range:	S. 403 - 408
Date:	2016
Publisher:	SPRINGER FRANCE
Place of Publication:	PARIS
ISSN:	1279-8517
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EXTENSOR TENDON INJURIES; ANATOMY; HAND Multiple languages Anatomy & Morphology; Radiology, Nuclear Medicine & Medical Imaging; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27731