The experience of treating mallet fingers by double locking-loop sutures

Abstract

Objective To introduce the clinical application and experience of treatment of mallet fingers by locking-loop suture compression technique. Methods From November 2009 to June 2015, 39 cases of mallet fingers were treated with double locking-loop sutures that were crisscross tunneled. The distal interphalangeal (DIP) joint was fixed with Kirschner wire in extension. Tunnels were then made at the base of the distal phalanx to allow passage of 4-0 non-absorbable sutures that wove through the extensor tendon insertion, crisscrossed and tied in a double locking-loop fashion to compress and secure the extensor tendon or the avulsed bone fragments against the insertion. Results All the patients were follow-up postoperatively from 12 to 29 months, with an average of 20 months. Primary wound healing was achieved in all the cases without nail deformation. There were no complications of tendon rupture, adhesion and fracture displacement. Recurrence of mallet deformity was seen in one case which was cured with arthrodesis. According to upper extremity function evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association, the results were graded as excellent in 22 cases, good in 16 cases, and fair in 1 case, with a 97.4% excellent and good rate. Conclusion The crisscross tunneled double locking-loop suture is a simple yet reliable technique that allows early functional exercise and leads to good clinical results in treating mallet fingers. Key words: Finger injuries; Treatment outcome; Mallet; Locking-loop