The optimal selection and treatment outcome of surgical procedures for chronic mallet finger deformity with fractures

Abstract

Objective To evaluate the efficacy of closed reduction and open reduction in the treatment of chronic mallet fracture.Methods From January 2006 to February 2012,81 patients with chronic mallet fracture were surgically treated.The interval between injury and operating time of these patients ranged from 8 to 21 weeks.Closed reduction and Kirschner wire fixation was carried out in 43 patients (group A).For cases when attempts of closed reduction and K-wire fixation did not achieve satisfactory results,simple open reduction and K-wire fixation was done in 21 patients (group B) while open reduction and extensor tendon insertion reconstruction with bone anchor was done in 17 patients (group C).Results Postoperatively the patients were follow-up for 6 to 24 months,with an average of 11.1 months.In group A results were excellent in 21 cases,good in 16 cases,fair in 4 cases and poor in 2 cases,with an overall 86.0％ satisfactory rate.In group B results were excellent in 9 cases,good in 9 cases,fair in 2 cases and poor in 1 case,with an overall 85.7 ％ satisfactory rate.In group C results were excellent in 6 cases,good in 8 cases,fair in 1 case and poor in 2 cases,with an overall 82.4％ satisfactory rate.Fractures healed after closed reduction and K-wire fixation in 91.9％ of the patients whose injuries were 8 to 14 weeks old.In patients whose injuries were more than 14 weeks old,79.5％ needed to have open reduction and K-wire fixation or extensor tendon insertion reconstruction with a mini bone anchor.Conclusion Proper application of different surgical procedures based on the differences in injury time can result in good treatment outcomes in treating mallet finger caused by bony avulsion fracture at the extensor tendon insertion. Key words: Tendon injuries; Fractures, closed; Surgical procedures, operative; Treatment outcome