• Byungsung Kim, Jae-Hwi Nho, Woo Jong Kim, Sungyong Park, Hak Soo Kim, Jahyung Kim, Hyoung Ye Kim, and Ki Jin Jung.
• Department of Orthopaedic Surgery, Soonchunhyang University Buchon Hospital, Bucheon.
• Medicine (Baltimore). 2020 May 29; 99 (22): e20219.

IntroductionEnchondromas arise from cartilaginous cells derived from the physis that persists throughout development. They are difficult to diagnose and are often discovered on radiographs after a trauma.Patient ConcernsWe discuss the case of a 32-year-old woman with a pathologic mallet fracture of the distal phalanx that was initially misdiagnosed as common mallet fracture.DiagnosisMagnetic resonance imaging revealed an eccentrically located lesion expanding to the cortex, with a high signal intensity at T2 weighted image, suggesting pathologic fracture.InterventionsWe performed a operation, involving curettage and bone grafting. Complete removal of the lesion was confirmed intraoperatively with the image intensifier, and the cavity was irrigated and subsequently filled with allogenous bone and demineralized bone matrix.OutcomesWith an uneventful recovery, she gradually return to normal function within 3 months. Her symptoms improved and nearly full range of motion of the finger was seen at 1-year follow-up.ConclusionOur case of pathologic mallet fracture was misdiagnosed as a simple fracture, suggesting that the mechanism of fracture and radiological diagnosis should be carefully considered.

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