Percutaneous Kirschner Wire Fixation of Acute Mallet Fractures Percutaneousely Reduced by Towel Clip

Chung Soo Han; Duke Whan Chung; Bi O Jeong; Hyun Chul Park; Jin Young Kim; Cheol Hee Park; Jin Sung Park

doi:10.12671/jkfs.2009.22.4.283

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Han, Chung, Jeong, Park, Kim, Park, and Park: Percutaneous Kirschner Wire Fixation of Acute Mallet Fractures Percutaneousely Reduced by Towel Clip

Original Article

Journal of the Korean Fracture Society 2009; 22(4): 283-287.

Published online: 30 October 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.4.283

Percutaneous Kirschner Wire Fixation of Acute Mallet Fractures Percutaneousely Reduced by Towel Clip

Chung Soo Han, M.D., Duke Whan Chung, M.D., Bi O Jeong, M.D., Hyun Chul Park, M.D., Jin Young Kim, M.D., Cheol Hee Park, M.D., Jin Sung Park, M.D.^*

Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.

^*Department of Orthopedic Surgery, School of Medicine, Gyeongsang National University, Jinju, Korea.

Address reprint requests to: Duke Whan Chung, M.D. Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Korea. Tel: 82-2-958-8368, Fax: 82-2-964-3865, dukech@khmc.or.kr

Received 7 May 2009 Revised 15 June 2009 Accepted 8 August 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

To analyze the treatment of clinical results of the percutaneous Kirschner wire fixation of acute mallet fractures percutaneousely reduced by towel clip.

Materials and Methods

From August 2005 to April 2009, we evaluated nine fingers in eight patients, more than three months follow up. The type of injury was a axial loading in seven cases and direct blow in two. The average follow-up period was 10.1 months (range: 3~41 months). The indication of operative treatment was the presence of large bony fragment or the palmar subluxation of the distal phalnx.

Results

The range of motion was 3.7° (0~10°) in extension lag and 76.7° (60~90°) of flexion of the distal interphalangeal joint.

Conclusion

The percutaneous Kirschner wire fixation of acute mallet fractures percutaneousely reduced by towel clip is one of the easy and simple method to stabilizing of bony mallet fracture.

Keywords: Mallet fracture, Distal phalanx, Towel clip, K-wire

Figures and Tables

Fig. 1

Preoperative lateral radiograph shows a displaced mallet fracture.

Fig. 2

Reduction using a towel clip under fluoroscopic guidance. Full extended DIP joint can reduce and compress the bone fragment by tips of a towel clip. Occasionally, manipulation of the distal phalanx with a towel clip is required to obtain an anatomic reduction.

Fig. 3

Maintaining reduction by a towel clip, a 0.035 inch K-wire is inserted through the bony fragment at a 45 angle into the of distal phalanx from dorsal to palmar cortex.

Fig. 4

After removal of a towel clip, a second K-wire is inserted through the bony fragment to distal phalanx.

Fig. 5

A temporally additional K-wire is inserted for stability.

Fig. 6

6 weeks follow up radiograph after the removal of the K-wires.

Table 1

Demographics and clinical outcome of the patients

^*K-wire: Kirschner wire.

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