Treatment of mallet finger caused by extensor tendon avulsion using double Kirschner wires technique

Abstract

Objective To explore the treatment options of mallet finger caused by avulsion fracture of the distal phalanx base and extensor tendon insertion lesion.Methods Twenty-four cases of mallet avulsion fractures of the distal phalanx,including 3 cases of open injury and 21 cases of closed injury,were treated using the extension block Kirschner wire technique.1/3 of the articular surface was involved in the largest fracture fragments.Double K-wires were inserted under C-arm fluoroscope monitoring to fix the fracture fragment and the distal interphalangeal (DIP) joint.The K-wires were removed after 4 weeks.A finger splint was used for another 6 weeks.The active range of motion of the DIP joint and roentgenogram were evaluated.Results Postoperatively the patients were follow-up for 6 to 12 months.Mallet deformity disappeared.No pain and sensory impairment was observed.Posteroanterior and lateral X-rays showed anatomical reduction and union of the avulsed fracture fragment.According to Dargan functional evaluation criteria,the outcomes were excellent in 17 cases,good in 6 cases and fair in 1 case.Conclusion This technique leads to satisfactory results and should be considered for treatment of mallet finger caused by extensor tendon insertion lesion and avulsion fracture. Key words: Fractures, bone; Internal fixators; Extensor tendon insertion; K-wire