Treatment of Mallet Finger Fracture by Extension Block K-wire Fixation

Jin Soo Suh; Chang Soo Lee; Young Joo Kim

doi:10.4055/jkoa.2008.43.3.316

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Suh, Lee, and Kim: Treatment of Mallet Finger Fracture by Extension Block K-wire Fixation

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2008; 43(3): 316-321.

Published online: 30 June 2008

DOI: https://doi.org/10.4055/jkoa.2008.43.3.316

Treatment of Mallet Finger Fracture by Extension Block K-wire Fixation

Jin Soo Suh, M.D., Chang Soo Lee, M.D., Young Joo Kim, M.D.

Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea.

Address reprint requests to Chang Soo Lee, M.D. Department of Orthopedic Surgery, Inje University Ilsan Paik Hospital, 2240, Daewha-dong, Ilsanseo-gu, Goyang 411-706, Korea. Tel: +82.31-910-7968, Fax: +82.31-910-7967, ostone01@ilsanpaik.ac.kr

Abstract

Purpose

The purpose of this study was to evaluate the outcomes of the extension block fixation technique for a bony mallet finger.

Materials and Methods

Thirty-five patients that received extension block fixation for bony mallet finger were enrolled in this study between July 2001 and October 2005. The fracture type was classified by the Wehbe and Schneider method. The average follow up period was 15 months, ranging between 12-52 months. The results were classified by the Crawford criteria.

Results

There was 30 cases of type I, 5 cases of type II and no cases of type III, with 11 cases of subtype A, 22 cases of subtype B, and 2 cases of subtype C. The average time from injury to operation was 12 days, which included three cases of over 28 days. The K-wire was removed 30 days after the operation, and joint exercises were initiated immediately. There were 10 cases with excellent outcomes, 18 cases with good outcomes, 4 cases with fair outcomes, and 3 cases with poor outcomes. The poor outcome had complications such as subluxation of the DIP joint, lag between injury to operation time (more than 4 weeks), and more than 1 mm displacement.

Conclusion

The extension block technique for the treatment of bony mallet finger is relatively simple and results in satisfactory bone union.

Keywords: Bony mallet finger, DIP joint, Extension block technique

Figures and Tables

Fig. 1

Operative method. The distal IP joint is held in flexion and a K-wire is passed through the extensor tendon 1-2 mm dorsal to the fragment (A). The DIP joint is extended and the fragment is reduced carefully (B). The second K-wire is inserted to the DIP joint (C).

Fig. 2

Time to operation results.

Fig. 3

A 46 years old male patient had an injury on his left ring finger 29 days previously. Preoperative radiograph showed 30 percent of joint involvement without joint subluxation (A). Monocortical extension block K-wire fixation is performed (B). Three months after the operation, the fracture was united but the joint was incongruent (C).

Fig. 4

A 15 years old male patient had an injury on the left middle finger 4 days previously. The preoperative radiograph showed 30 percent of joint involvement without joint subluxation (A). Bicortical extension block K-wire fixation is performed (B). 3 months after the operation, the fractured bone had fused well (C).

Table 1

Classification (Wehbe and Schneider)

Table 2

Objective Results (Crawford Criteria)

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