Prognostic Factors of the Extension Block Technique for the Bony Mallet Finger

Soo-Bong Hahn; Kwang-Hwan Park; Yun-Rak Choi; Ho-Jung Kang; Jung-Kil Lee

doi:10.4055/jkoa.2010.45.2.127

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Hahn, Park, Choi, Kang, and Lee: Prognostic Factors of the Extension Block Technique for the Bony Mallet Finger

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2010; 45(2): 127-132.

Published online: 19 April 2010

DOI: https://doi.org/10.4055/jkoa.2010.45.2.127

Prognostic Factors of the Extension Block Technique for the Bony Mallet Finger

Soo-Bong Hahn, M.D., Kwang-Hwan Park, M.D., Yun-Rak Choi, M.D., Ho-Jung Kang, M.D., Jung-Kil Lee, M.D.

Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to: Yun-Rak Choi, M.D. Department of Orthopaedic Surgery, Yonsei University College of Medicine, #134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea. TEL: +82-2-2228-2190, FAX: +82-2-363-1139, yrchoi@yuhs.ac

Received 27 October 2009 Accepted 23 December 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to evaluate the clinical results and prognostic factors of the extension block technique for treating a bony mallet finger.

Materials and Methods

Between July 2002 and January 2009, forty-nine patients who underwent the extension block technique for a bony mallet finger were evaluated. The minimum period of follow up was 6 months. The type of fracture was classified by the Wehbe and Schneider method. The results were evaluated by the Crawford classification. The prognostic factors were analyzed according to age, gender, the timing of the surgery, the mallet fragment angle and the residual displacement.

Results

According the Crawford classification, there were 22 excellent, 20 good, 6 fair and 1 poor results. The poor prognostic factors were an older patient age, subluxation, a smaller mallet fragment angle and smaller postoperative displacement (p<0.05).

Conclusion

The prognostic factors of the extension block technique for bony mallet finger were the patient age, subluxation, the mallet fragment angle (more than 30 degrees) and the postoperative displacement.

Keywords: bony mallet finger, extension block technique, prognostic factor, mallet fragment angle

Figures and Tables

Figure 1

Mallet fragment angle. ^*Mallet fragment angle (°)=90°-{An acute angle between an axis of distal phalanx (dotted line) and a line of fracture (solid line)}.

Figure 2

Lateral radiograph of right 3^rd finger. (A) Four days ago, a 37-year-old male patient had an injury on his right 3^rd finger. Preoperative radiograph showed 70 percents of joint involvement without a joint subluxation. Mallet fragment angle was 55°. (B) Extension block technique was performed. (C) At postoperative 3 months, the fracture was united and the joint was congruent. Excellent result was noted according to the Crawford classification.

Figure 3

Lateral radiograph of right 5^th finger. (A) Fourteen days ago, a 24-year-old male patient had an injury on his right 5^th finger. Preoperative radiograph showed 50 percents of joint involvement with a joint subluxation. Mallet fragment angle was 20°. (B) Extension block technique was performed. (C) At postoperative 3 months, the fracture was united but the joint was incongruent. Fair result was noted according to the Crawford classification.

Table 1

Wehbe and Schneider's Classification

DIP, Distal interphalangeal.

Table 2

Crawford's Criteria

Table 3

Clinical Results

^*Mean value; ^†Mean visual analogue scale (0-10).

Table 4

Correlation with Mallet Fragment Angle

Bivariate correlation analysis (pearson correlation coefficient).

Table 5

Prognostic Factors for Clinical Results (Crawford Classification^*)

Bivariate correlation analysis (pearson correlation coefficient); ^*Excellent= 4, Good=3, Poor=2, Bad=1.

Table 6

Clinical Results according to Mallet Fragment Angle

Independent t-test; ^*Excellent=4, Good=3, Poor=2, Bad=1.

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