Abstract
Introduction
Various surgical treatments such as extension block pinning have been proposed for acute bony mallet finger. We evaluated the clinical results of tension wire fixation technique for the treatment of nonunion of mallet fracture after failed mallet finger surgery.
Materials and methods
Nine male patients were treated with open tension wire fixation for chronic nonunion of mallet fracture after extension block pinning surgery failed. The mean age was 29.3 years (range 18–47). We assessed bone union in simple radiographs. Crawford’s and Bischoff functional score was used to assess the functional outcome.
Results
The mean follow-up period was 45.8 months (range 18–74). Clinical and radiographic bone unions were achieved in eight of nine patients with average time of 31 days (range 23–41). Mean extension lag at final follow-up was 7° (range 0–25). Four patients showed excellent, three patients showed good and two patients showed fair results on the Crawford’s score scale. With Bischoff functional score, all patients were categorized as excellent.
Conclusions
Tension wire fixation can be a good second-line reconstructive surgery for the treatment of mallet fracture after extension block failed, so that patients can avoid arthrodesis or complex tendon transfer as a salvage procedure.
Similar content being viewed by others
References
Miura T (2013) Extension block pinning using a small external fixator for mallet finger fractures. J Hand Surg Am 38:2348–2352
Zhang X, Meng H, Shao X, Wen S, Zhu H, Mi X (2010) Pull-out wire fixation for acute mallet finger fractures with k-wire stabilization of the distal interphalangeal joint. J Hand Surg Am 35:1864–1869
Hamas RS, Horrell ED, Pierret GP (1978) Treatment of mallet finger due to intra-articular fracture of the distal phalanx. J Hand Surg Am 3:361–363
Wehbe MA, Schneider LH (1984) Mallet fractures. J Bone Joint Surg Am 66:658–669
Jupiter JB, Sheppard JE (1987) Tension wire fixation of avulsion fractures in the hand. Clin Orthop Relat Res 214:113–120
Fritz D, Arora R, Gabl M, Lutz M (2008) Modified Ishiguro extension block technique for fracture-dislocation of the distal interphalangeal joint. Oper Orthop Traumatol 20:38–43
Inoue G (1992) Closed reduction of mallet fractures using extension-block Kirschner wire. J Orthop Trauma 6:413–415
Ishiguro T, Itoh Y, Yabe Y, Hashizume N (1997) Extension block with Kirschner wire for fracture dislocation of the distal interphalangeal joint. Tech Hand Up Extrem Surg 1:95–102
Lee YH, Kim JY, Chung MS, Baek GH, Gong HS, Lee SK (2009) Two extension block Kirschner wire technique for mallet finger fractures. J Bone Joint Surg Br 91:1478–1481
Pegoli L, Toh S, Arai K, Fukuda A, Nishikawa S, Vallejo IG (2003) The Ishiguro extension block technique for the treatment of mallet finger fracture: indications and clinical results. J Hand Surg Br 28:15–17
Tetik C, Gudemez E (2002) Modification of the extension block Kirschner wire technique for mallet fractures. Clin Orthop Relat Res 404:284–290
Kakinoki R, Ohta S, Noguchi T, Kaizawa Y, Itoh H, Duncan SF, Matsuda S (2013) A modified tension band wiring technique for treatment of the bony mallet finger. Hand Surg 18:235–242
Sonoda A, Kishimoto H, Uchino K, Muta M, Muroya M (2003) Treatment of chronic mallet fractures with tension wire fixation. J Jpn Soc Surg Hand 20:660–663
Hiwatari R, Kuniyoshi K, Aoki M, Hashimoto K, Suzuki T, Takahashi K (2012) Fractional Fowler tenotomy for chronic mallet finger: a cadaveric biomechanical study. J Hand Surg Am 37:2263–2268
Kanaya K, Wada T, Yamashita T (2013) The Thompson procedure for chronic mallet finger deformity. J Hand Surg Am 38:1295–1300
Song JH, Lee JY, Chung YG, Park IJ (2012) Distal interphalangeal joint arthrodesis with a headless compression screw: morphometric and functional analyses. Arch Orthop Trauma Surg 132:663–669
Crawford GP (1984) The molded polythene splint for mallet finger deformities. J Hand Surg Am 9:231–237
Bischoff R, Buechler U, De Roche R, Jupiter J (1994) Clinical results of tension band fixation of avulsion fractures of the hand. J Hand Surg Am 19:1019–1026
Damron TA, Engber WD (1994) Surgical treatment of mallet finger fractures by tension band technique. Clin Orthop Relat Res 300:133–140
Acknowledgments
This work was supported by the Global Frontier R&D Program on “Human-centered Interaction for Coexistence” funded by the National Research Foundation of Korea grant funded by the Korean Government (MSIP) (NRF-M1AXA003-2010-0029748). This work was supported by the Global Frontier R&D Program on “Human-centered Interaction for Coexistence” funded by the National Research Foundation of Korea grant funded by the Korean Government (MEST; NRF-M1AXA003-2011-0028358).
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lee, HJ., Jeon, IH., Kim, PT. et al. Tension wire fixation for mallet fracture after extension block pinning failed. Arch Orthop Trauma Surg 134, 741–746 (2014). https://doi.org/10.1007/s00402-014-1968-x
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-014-1968-x