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Tension wire fixation for mallet fracture after extension block pinning failed

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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.

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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).

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Correspondence to In-Ho Jeon.

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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

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  • DOI: https://doi.org/10.1007/s00402-014-1968-x

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