title: Anatomic reduction of mallet fractures using extension block and additional intrafocal pinning techniques.
abstract: BACKGROUND
  The purpose of this article is to report the efficacy of the extension block pinning and additional intrafocal pinning technique applied to cases whose mallet fractures were not reduced with extension block pinning alone.
  
  
  METHODS
  We retrospectively reviewed 14 digits with 14 patients who were treated with the extension block pinning and additional intrafocal pinning technique. There were eight men and six women with an average age of 34 years. The average articular surface involvement was 52%. The average follow-up was 16 months and the mean time from injury to operation was 23 days.
  
  
  RESULTS
  All the cases achieved anatomic reduction of fractures. By Crawford's classification, 9 were excellent and 5 were good. The average active flexion of the distal interphalangeal joint was 78 degrees and the average extension loss was 1.8 degrees. Bone union was observed in all cases after a postoperative mean of 38.4 days. Complications such as skin necrosis, fracture of bony fragments, and nail-plate deformity were not found.
  
  
  CONCLUSIONS
  Additional intrafocal pinning technique is considered a simple and useful method to obtain anatomic reduction of mallet fractures in cases where extension block pinning alone is insufficient to restore the anatomic configuration of the articular surface.
authors.affiliation: Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Duke-Whan
authors.initials: DW
authors.lastname: Chung
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D005260:Female; D050278:Finger Phalanges / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult