Modified extension-block K-wire fixation technique for the treatment of bony mallet finger.
This article describes the treatment of a bony mallet finger deformity using 2 extension-block Kirschner wires (K-wires) with a transarticular K-wire fixation technique for precise alignment of the terminal extensor tendon-bone relationship and effective immobilization of the distal interphalangeal joint. Twenty-nine patients (33 fingers) with a bony mallet finger deformity and fracture fragment involving more than one-third of the articular surface were treated surgically. The fracture fragment was fixed and the mallet finger deformity was corrected in all patients using modified extension-block K-wires (2 dorsal extension-block pins) with a transarticular K-wire (volar side pin) fixation technique. Active motion of the proximal interphalangeal and metacarpophalangeal joints was not restricted. The wires are removed in the clinic 6 weeks postoperatively when the bridging trabeculae were observed in the radiographs, and immobilization in a stock splint was continued for an additional 2 weeks. According to Crawford's evaluation criteria, there were 24 (73%) excellent, 7 (21%) good, and 2 (6%) fair results. Three patients showed radiological signs of mild degenerative changes, which did not limit their daily activities. Nail ridging occurred in 3 cases (9%), which disappeared after an average of 6 months with normal growth, and mild scarring at the dorsal pin site occurred in 2 cases (6%). Modified extension-block K-wires with a transarticular K-wire fixation technique is an acceptable alternative treatment modality for the management of bony mallet finger deformities with or without subluxation of the distal phalanx.
Lee
Sang Ki
SK
Department of Orthopedic Surgery, Eulji University College of Medicine, 1306 Dunsan-dong, Seo-gu, Daejeon 302-799, Korea. sklee@ eulji.ac.kr
Kim
Kap Jung
KJ
Yang
Dae Suk
DS
Moon
Kyung Ho
KH
Choy
Won Sik
WS
D000293:Adolescent; D000328:Adult; D001864:Bone Wires; D005260:Female; D005383:Finger Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006227:Hand Deformities, Acquired / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D055815:Young Adult