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Surgical Finger Cure For Hammer

Article written by: ANDREI BOGDAN, MD, Orthopedics-traumatology doctor

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For all traumatic or chronic diseases of the musculoskeletal system, the Centrokinetic private clinic in Bucharest is prepared with an integrated Orthopedic Department, which offers all the necessary services to the patient, from diagnosis to complete recovery.
The Department of Orthopedic Surgery of the Centrokinetic Clinic is dedicated to providing excellent patient care and exceptional education for young physicians in the fields of orthopedic surgery and musculoskeletal medicine.  

Discover the open MRI imaging center in our clinic. Centrokinetic has a state-of-the-art MRI machine, dedicated to musculoskeletal conditions, in the upper and lower limbs. The MRI machine is open so that people suffering from claustrophobia can do this investigation. The examination duration is, on average, 20 minutes.

Centrokinetic attaches great importance to the entire medical act: investigations necessary for correct diagnosis (ultrasound, MRI), surgery, and postoperative recovery.

Mallet finger is a deformation in dorsiflexion of the first phalanx, in plantar flexion of the second, and the distal phalanx remains in a normal position compared to the second. 
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The cause (etiopathogenesis) is associated with other congenital or acquired malformations of the foot and occurs as a consequence of an imbalance between the flexor and extensor muscles of the toes. It is most commonly located at the level of the 2nd finger. Thus, dislocations (loss of contact between the articular surfaces) occur at the level of the metatarsal head and the base of the proximal phalanx, but also the first interphalangeal joint. Consequently, the metatarsal collapses along with the anterior plantar arch, and later, muscular and capsular retractions appear.

The treatment depends on the degree of damage to the finger. For cases where the deformity can be reduced to the clinical examination, you can opt for muscle tension. In irreducible cases, interphalangeal arthrodesis is the optimal solution.

The surgical technique consists of resection of the head or distal extremity of the proximal phalanx or resection and arthrodesis of the proximal interphalangeal joint (surgical blockage of this joint). Under spinal anesthesia, an incision of about 2 cm is made in the upper part of the finger, the joint capsule and the tendon of the long extensor muscle of the finger are highlighted, the joint is opened and 2 mm from the head of the proximal phalanx and the base of the distal phalanx are resected.

Fix the 2 bone surfaces with a K brooch, which will remain in this position for 6-8 weeks, then being removed.

 The K brooch will remain outside the finger 4-5mm, requiring care in the postoperative period to heal.  

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Postoperative

 After the operation, the patient remains hospitalized for 1 day. He will receive pain medication and antibiotics during hospitalization. The operated limb is not immobilized, and the patient is advised to make ankle exercises, from the first postoperative day. Free walking is allowed immediately, without the need for crutches, given that the chosen intervention was joint debridement. In the case of arthrodesis, patients will wear a compressive bandage on the foot for 5 days and will use a special shoe when walking, which correctly distributes the body weight. Patients can return to daily activities quickly, up to 3-4 weeks. 

At home

Although recovery after this operation is much faster than a classic intervention, it will still take a few weeks for you to fully recover the operated joint. You should expect pain and discomfort for at least a week postoperatively. You can use a special ice pack, which will reduce the pain and inflammation. You must be careful not to lean on the operated area in the first weeks because the pain and discomfort can worsen. You can take a bath, but without wetting the bandage and incisions. The threads are suppressed at 14 days postoperatively.

At 6 weeks postoperatively, an X-ray is necessary to see how the affected joint heals. Driving is allowed after 6 weeks, and hard physical work after 12 weeks.

Physical therapy plays a very important role in the rehabilitation program, and the exercises must be followed by a physical therapist until the end of the recovery period.

It is very important to follow the recovery program strictly and seriously for the surgery to be a success. Our medical team works on average with the patient after this intervention, 12-16 weeks until complete recovery of the operated area.

Following any surgery, medical recovery plays an essential role in the social, professional, and family reintegration of the patient. Because we pursue the optimal outcome for each patient entering the clinic, recovery medicine from Centrokinetic is based on a team of experienced physicians and physical therapists and standardized medical protocols.

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