Tubiana classification of mallet finger

Last revised by Andrea Molinari on 15 Feb 2024

Tubiana classification considers the size of the bony fragment and subluxation. It includes tendinous mallet deformities and correlates bone fragment size with volar subluxation.

Mallet fractures are avulsion fractures of the distal phalanx peri- or intra-articular base with involvement of the extensor tendon insertion.

Classification

Tubiana classification describes four types of lesions 1:

  • type I: subcutaneous tendon rupture

  • type II: bony avulsion at the base of the distal phalanx

  • type III: fracture >1/3 of the articular surface with volar subluxation

  • type IV: growth plate fracture

All mallet fingers should be treated conservatively with a dorsal glued splint except for type IV lesions that is not reduced despite a dorsal glued splint but with extra-articular fixed pinning.

History and etymology

Raoul Tubiana (1915-2013), French plastic surgeon, was a pioneer in hand surgery and reconstructive surgery.

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