Evaluation of tautening method in repair of advanced mallet finger without bone fracture.

Many different repair methods have been described in the frequently seen mallet finger deformity, but without consensus. The present study aimed to present an alternative tautening technique in mallet finger repair and to compare it versus classical direct repair. Patients with untreated chronic mallet finger of more than three months' progression, treated surgically between March 2017 and October 2020, were included. Two surgical methods were applied to restore extensor function of the distal interphalangeal joints. In the first group, the granulation tissue was excised and the extensor tendon was repaired directly. In the second group, granulation tissue was not excised, and the extensor tendon was tautened by plication. Outcomes were evaluated according to Miller's criteria. Fort-six patients were included: group 1, 25 patients; group 2, 21 patients. Mean age in group 1 was 36.2 years and 33.4 years in group 2. Mean follow-up in group 1 was 14.8 months and 13.9 in group 2. Extensor lag was similar (5.6°) in both groups at the end of the sixth month. On Miller's mallet finger criteria, group 1 scored 3.4 points and group 2 3.4 points (p > 0.05). The tendon tautening method helps to start physiotherapy early, the learning curve is short, and it provides functionally positive results and a low complications rate. We think that this method should be evaluated in chronic mallet finger deformities without bone fracture.

Lateral malleolar region defects with exposed implants: proximally based peroneus brevis muscle flap.

OBJECTIVE: Reconstruction of lateral malleolar region defects with exposed implants is a problematic situation for the reconstructive surgeon because there are limited options. The objective of our study was to revise the management of these defects and point out the role of proximally based peroneus brevis muscle flap. METHOD: Patients with an implant exposed tissue defects of the lateral malleolar region were evaluated retrospectively. All defects reconstructed with proximally based peroneus brevis muscle flap were included in this study. RESULTS: Of the 17 patients identified the mean age was 37.1 years (range 16-58 years). The size of the defects were 2-9cm in length (mean: 4.9cm) and 2-4cm in width (mean: 2.6cm). All defects were successfully covered with proximally based peroneus brevis muscle flaps combined with split-thickness skin grafts. All flaps healed with no complication or need for secondary surgery. The mean follow-up was18.8 months (range 12-32 months). CONCLUSION: Proximally based peroneus brevis muscle flap is a good alternative for reconstruction of lateral malleolar region defects with reliable blood supply, short surgical time, and minimal donor site morbidity.