Surgical management of mallet finger with extension block pinning
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20182031Keywords:
Surgical management, Mallet finger, Extension block pinningAbstract
Background: Various surgical and nonsurgical treatments have been described in the management of mallet finger. The purpose of this study is to evaluate the effectiveness of extension block pinning in the management of displaced mallet finger fractures.
Methods: We conducted a retrospective study in which extension block pinning was done for displaced Mallet finger fractures. We included 10 patients in our study who were treated between 2016 and 2018. Fractures were classified according to Wehbe and Schnieder’s classification. All the procedures were done using ring block anaesthesia. Postoperative radiographic assessment was done at each follow up at 15 days interval. Wires were removed after radiologic confirmation of fracture healing. Assessment of the outcome was done using Crawford’s criteria.
Results: According to Wehbe and Schnieder’s classification IIB type was the most common. All fractures involved more than 30% of articular surface. Average operative time was 30 mins. Congruent anatomical reduction was achieved in all the patients (intrarticular step off less than 1 mm). Average healing time of the fractures was 40 days. Seven out of the ten patients had excellent results. No wire related complications were seen in our patients.
Conclusions: Extensor block pinning when performed accurately is an easy, economical and effective technique in treatment of mallet fingers.
References
Hofmeister EP, Mazurek MT, Shin AY, Bishop AT. Extension block pinning for large mallet fractures. J Hand Surg Am. 2003;28(3):453–9.
Chung DW, Lee JH. Anatomic reduction of mallet fractures using extension block and additional intrafocal pinning techniques. Clin Orthop Surg. 2012;4(1):72–6.
Damron TA, Engber WD. Surgical treatment of mallet finger fractures by tension band technique. Clin Orthop Relat Res. 1994;(300):133-40.
Jupiter JB, Sheppard JE. Tension wire fixation of avulsion fractures in the hand. Clin Orthop Relat Res. 1987;(214):113-20.
Stark HH, Gainor BJ, Ashworth CR, Zemel NP, Rickard TA. Operative treatment of intra-articular fractures of the dorsal aspect of the distal phalanx of digits. J Bone Joint Surg Am. 1987;69(6):892-6.
Ishiguro T. A new method of closed reduction for mallet fractures. Cent Jpn J Orthop Trauma Surg. 1988;31:2049–51.
Wehbe´ MA, Schneider LH. Mallet fractures. J Bone Joint Surg. 1984;66A:658–69.
Crawford GP. The molded polythene splint for mallet finger deformities. J Hand Surg. 1984;9:231–7.
Lester B, Jeong GK, Perry D, Spero L. A simple effective splinting technique for the mallet finger. Am J Orthop. 2000;29:202–6.
Smillie IS. Mallet finger. Br J Surg. 1937;24:439–45.
Abouna JM, Brown H. The treatment of mallet finger. The results in a series of 148 consecutive cases and a review of the literature. Br J Surg. 1968;55:653–7.
Elliott RA Jr. Splints for mallet and boutonniere deformities. Plast Reconstr Surg. 1973;52:282–5.
Rayan GM, Mullins PT. Skin necrosis complicating mallet finger splinting and vascularity of the distal interphalangeal joint overlying skin. J Hand Surg. 1987;12:548–52.
Inoue G. Closed reduction of mallet fractures using extension-block Kirschner wire. J Orthop Trauma. 1992;6:413–5.
Darder-Prats A, Fernandez-Garcia E, Fernandez-Gabarda R, Darder-Garcia A. Treatment of mallet finger fractures by the extension-block K-wire technique. J Hand Surg. 1998;23:802–5.