Modified Pull-Out Wire Suture Technique for the Treatment of Chronic Bony Mallet Finger

Abstract

Twenty-three patients with a chronic bony mallet finger deformity (more than 3 months after the injury) and fracture fragment involving more than one-third of the articular surface underwent surgical treatment. The fracture fragment was fixed, and the mallet finger deformity was corrected in all patients using a modified pull-out wire (wire passed through the dorsal fragment directly) with a transarticular Kirschner wire fixation technique. Active motion of the proximal interphalangeal and metacarpophalangeal joints was not restricted. According to Crawford's evaluation criteria, there were 17 excellent, 4 good, and 2 fair results. Four patients showed radiologic signs of mild degenerative changes, which did not limit their daily activities. The modified pull-out wire suture with the transarticular Kirschner wire fixation technique provides an alternative and acceptable treatment modality for the treatment of chronic bony mallet finger deformities with or without subluxation of the distal phalanx.