Simple Suture Research Articles

101. Posterior Gastric Perforation After Blunt Abdominal Trauma in Geriatric Patient: A Rare Case

Introduction: Blunt abdominal trauma commonly results from traffic accidents, with solid organ injuries being the most frequent. Gastric perforation, particularly of the posterior wall, is rare. We present the case of a 79-year-old male with a delayed diagnosis of posterior gastric perforation following blunt trauma. Case: A 79-year-old male, five days post-motorcycle accident, presented with severe abdominal pain and distension. He was fully conscious and hemodynamically stable. Physical examination revealed abdominal tenderness and guarding without external bruising. Radiography showed subdiaphragmatic free air, and hemoglobin was 11 g/dL. Exploratory laparotomy found 200 cc of free fluid, and a 1.5 cm full-thickness posterior gastric perforation near the prepyloric region was identified after opening the lesser sac. The perforation was closed with simple sutures. The patient developed pneumonia on day 6 postoperatively and was discharged on day 15 with uneventful recovery. Conclusions: Posterior gastric perforation following blunt trauma is uncommon but associated with high mortality. Early diagnosis and prompt surgical intervention are essential for improving prognosis.

Concave-to-convex curve conversion of fiber cells correlates with Y-shaped suture formation at the poles of the rodent lens

The eye lens contains convexly curved fiber cells that align in concentric layers around the lens anterior-posterior pole axis. For lens fiber differentiation at the equator, cells elongate with their apical and basal tips migrating towards the anterior and posterior poles, respectively. At each pole, the fiber tips meet opposing tips of other fiber cells, to form a suture. Although umbilical or point sutures are observed in fish and birds, line, Y- or star-shaped sutures are detected in other vertebrate lenses. Sutures that do not converge at the point are thought to result from intricate movements of the fiber tips, rather than a straightforward migration along a meridional path. The triggers that give rise to these variations are currently not understood. Our findings revealed that in the mouse embryo, the early-stage lens contains only concave curved fibers, and later, a zone of concave-to-convex curve conversion develops. At this point, a nascent suture in a linear shape appears at the posterior pole and subsequently progresses into a V-shape. This V-shape appears to further develop into a Y-shape as a branch extends from the apex of the V-shape. In lens of zebrafish and Xenopus larvae that form point sutures, this curve-conversion zone is not observed. In lens of adult birds (e.g. zebra finch) that form a point suture, these too also lack a curve-conversion zone. In our previous studies, we demonstrated that murine lens fibers undergoing curve conversion extend membrane protrusions, or lamellipodia, at their basal membranes. In line with this, we did not observe protrusions at the basal tips of fibers in the non-mammalian lenses of zebrafish, Xenopus, and zebra finch in which curve conversion does not occur. We propose that the concave-to-convex conversion in rodent lenses introduces defined paths for fiber cell tips, leading to a more elaborate and complex suture formation, compared to the simple point suture of lower vertebrates.

Novel Technique to Close Stellate Corneal Lacerations.

The study was performed to evaluate and optimize a novel technique to close stellate corneal lacerations in a wet laboratory environment. Twenty-one ex vivo porcine eyes with standardized, experimentally created stellate corneal lacerations were assigned to one of three surgical repair techniques. In Group 1 (n = 9), lacerations were closed with simple interrupted sutures only. In Group 2 (n = 7), a large-radius central purse string was used in addition to simple interrupted sutures. In Group 3 (n = 5), a small-radius central purse string was used in addition to simple interrupted sutures. Wound stability was assessed by determining the intraocular pressure (IOP) at which wound leak occurred. Group 3 eyes demonstrated a mean wound leak IOP of 56.1 mm Hg (range 32-90.3) compared with groups 1 and 2, which demonstrated mean wound leak IOPs of 6.4 mm Hg (range 1.9-19) and 13.3 mm Hg (range 2.8-31), respectively. These differences were highly statistically significant (P<0.002 and P<0.015, respectively, compared with Group 3). The use of a small-radius internal purse-string suture, when combined with simple interrupted sutures, produced a highly effective watertight closure in experimentally created stellate corneal lacerations, significantly outperforming approaches using only interrupted sutures or a large-radius purse string. The use of a small-radius purse-string suture should be considered for clinical use in the repair of stellate corneal lacerations.

MEDIAN EPISIOTOMY APPROACH IN A MINIATURE POMERANIAN WITH VULVAL HYPOPLASIA: A CASE REPORT

This case report details the episiotomy approach employed in managing vulval hypoplasia in a two year old Miniature Pomeranian bitch. The animal was presented to the Teaching Veterinary Clinical Complex, Veterinary Gynaecology and Obstetrical Unit, Madras Veterinary College, displaying a history of greenish black discharge and continuous straining for two hours. The animal was bred before 64 days. Physical examination revealed a small vaginal opening, measuring approximately 1.5 cm in length. Digital examination indicated fetal hind limbs and tail extending into the vaginal passage, while all other vital parameters were within the normal range. Attempts to induce uterine contractions using Inj. Oxytocin and 10 % Calcium gluconate in 5 % DNS proved unsuccessful. Therefore, under local anesthesia (2 % Lignocaine injection), median episiotomy was made and a single live male puppy was successfully delivered with mild traction. Closure of the incision site was accomplished using PGA 1/0 with a simple interrupted suture pattern. The patient had uneventful recovery after 5 day treatment regimen, involving a single dose of subcutaneous Inj. Cefovecin (antibiotic) and anti-inflammatory drugs, along with meticulous wound management.

Reconstruction of deep and perforating corneal defects in dogs-A review (Part III/III): The use of corneal sutures and reporting of ocular discomfort.

The surgical reconstruction of severe corneal disease is a common and crucial component of the clinical practice of veterinary ophthalmology. The first part of the present review described procedures that utilize autogenous ocular tissues, homologous donor tissues, and heterologous donor tissues in dogs, while the second part reviewed the use of biomaterials and keratoprosthetics in this species. This third part is dedicated to the review of the use of corneal sutures including suture type and suture pattern in corneal reconstruction of small animals including dogs and cats. The review also focused on the way studies report postoperative ocular discomfort/pain and how this is treated. Lastly, the author briefly presents the simple but effective techniques available to bury corneal knots for corneal reconstructive surgery in small animal patients, such as the "tugging" and "deep-superficial-superficial-deep" methods for simple interrupted sutures, and the adaptation of the latter for simple continuous sutures.

Total Ankle Arthroplasty Incision Management: What Matters? A Systematic Review

Modern advancements in total ankle arthroplasty techniques and implants have increased the popularity of this treatment for ankle osteoarthritis. The preeminent approach for ankle replacement involves an anterior incision, however, wound complications with this approach provide a persistent challenge to surgeons. The present study was conducted to synthesize current data on ankle replacement wound complications via an anterior approach. A systematic review was completed including studies published from 1993 to present that employed an anterior approach and had precise criteria for wound healing and revisions. Twenty-nine studies, with level 3 to 4 evidence and moderate to serious bias, were included for a total of 6,986 ankle arthroplasties. The rate of wound healing without any complication was 90.38%. Minor dehiscence occurred in 6.00% of cases, while major wounds or infections occurred in 3.62%. Across 2,966 implants, the rate of major wounds or infections decreased from 7.03% before 2013 to 4.75% after 2013 (p = 0.034). Limited comparisons involving simple suture closure to various adjunct wound management techniques including negative pressure wound therapy, 2-octyl cyanoacrylate, platelet-rich plasma, dehydrated human amniotic membrane allograft, non-invasive skin expansion strips, compression wound dressings, tranexamic acid, surgical helmets, tourniquets, ankle arthrodesis, and lateral approach ankle arthroplasty, yielded non-significant differences (p > 0.18). Therefore, contemporary techniques, patient selection, and current implants may be leading to better soft tissue healing. As ankle replacement continues to surge in popularity, further research is needed to evaluate causative factors in successful anterior incision healing. Level of Clinical Evidence3

A simple suture technique to repair iatrogenic iridodialysis post cataract surgery: A case report

Disinsertion of iris from its attachment is called iridodialysis. Symptomatic and large iridodialysis often requires repair. Repair of iridodialysis is complex and often require special instruments and good surgical expertise. We describe a simple suture technique to repair an iatrogenic iridodialysis caused during small incision cataract surgery in a 62 year-old patient. This technique is simple and involves very minimal tissue handling. The primary aim of us doing this procedure is the functional and cosmetic result which can be obtained in the same sitting as the primary procedure with common available instruments.

The Neo-Pitanguy Ligament: A Three-Flap Technique For Skin Tensioning.

Creating a stable, long-lasting supratip break continues to be a challenge, particularly in patients with moderate to severe skin thickness. Multiple techniques have been previously described to address this, including Pitanguy's ligament preservation, re-suturing, and cartilage frame alterations to increase the tip-to-septal angle differential. Each have noteworthy limitations. The senior author developed a novel technique which utilizes the native Pitanguy ligament augmented by two bilateral, medially-based superficial musculo-aponeurotic system (SMAS)/soft tissue flaps. This reduces supratip dead space, prevents tissue glide while controlling supratip/tip shape and position. Twenty-six (n=26) primary rhinoplasties in which the supratip and tip skin sleeve was of appropriate thickness were selected and followed for 1-year post operatively. The tri-laminar neo-Pitanguy ligament (NPL) technique was employed in all patients. Every patient maintained a varied degree of supratip break at an average follow up time of 14 months (range: 12-16 months). There was one revision requiring local anesthesia. No patients requested or were indicated for a return to the operating room. No cases of post-operative pollybeak deformity were observed. The power of this novel supratip control technique is multidimensional. It allows the surgeon to precisely control the location of supratip break, creating a broad based, diamond-shaped supratip depression. Tri-lamination with the use of the two SMAS/soft tissue flaps provides added strength, control, and long-term stability compared to simple suturing. Soft tissue tensioning above, around, and below the new tip complex prevents dorsal skin tissue glide and further secures the infratip/columella in appropriate position.

Generic diversity and septal complexity in Cretaceous ammonoids. Effects of oceanic anoxic events on the ammonoid evolutionary dynamic

AbstractThis paper analyzes the relationship between the number of genera of Cretaceous planiespiral ammonoids and their sutural complexity estimated by their fractal dimension. It is confirmed that the dynamics of generic diversity is associated with the appearance/disappearance of simple suture genera, which are not ascribed to a particular family. The maximum oscillations of generic diversity occur in the Aptian and Albian which are associated with large variations in the number of genera with simple sutures. From the Middle Campanian there is a continued loss of diversity until the end of the Maastrichtian linked to a net reduction of single suture genera. The direct relationship between the number of genera and the range of septal complexity in each substage indicates that different degrees of septal complexity are different ecomorphological strategies of adaptation to different niches. This result confirms that the specialist forms are those with simple sutures while the genera with complex septa are either generalist forms or are adapted to environments that do not undergo major fluctuations over geological time. The ammonoid generic diversity recorded dynamics is different from that of other marine invertebrates, reflecting paleobiological and/or taphonomic differences. The symmetrical distribution of septal complexity values points to the relative fidelity of the fossil record of Cretaceous ammonoids. The effect of seven oceanic anoxic events of the Cretaceous on the number of genera and septal complexity is analyzed, obtaining no statistically distinguishable effects of the oscillations of these variables with respect to those occurring in other intervals where such events are not recorded.

Pleomorphic adenoma of hard palate: Review of updated literature and "case report".

Pleomorphic adenoma (PA) is a rare benign tumor mainly affecting the major salivary glands, known for its diverse histological appearances that can mimic malignancies. When it occurs in the hard palate it present diagnostic and management challenges compared to other sites due to the anatomical location and potential proximity to critical structures. This case reports a rare presentation PA starting as an ulcer, alongside a review of rare cases of PA reported in last 5 years. We aim to highlight clinical challenges and emphasize the need for awareness in diagnosis of this diverse entity amongst the clinicians before reaching a definitive conclusion. A 41-year-old female reported an asymptomatic large swelling on the right side of the posterior palatal region. Clinical diagnosis revealed a firm, rubbery, and non-tender swelling of approximately 4 cm × 4 cm diameter. A triangular incisional biopsy was performed to confirm the diagnosis. The histopathological evaluation confirmed the presence of a PA with a well-encapsulated and compressed salivary gland. A wide surgical dissection was made to remove the entire encapsulated tumor mass, including the mucoperiosteum and eroded bone of the palate. The borderline of the tumor was carefully identified in the surrounding healthy tissue. The hemostasis was obtained using a simple interrupted suture. The diagnosis of PA is difficult as it usually involves extensive squamous and mucous metaplasia, confusing it with malignant disorders. Histopathological and clinical examinations are important for differentiating this lesion from other tumors. Complete surgical excision is reported as the first line of treatment.

Closing the internal opening with a rectal advancement flap increases the efficacy of mesenchymal stem cell injection for complex Crohn's disease anal fistulas.

The efficacy of injections of mesenchymal stem cells (MSC) for anal fistula treatment may be impaired by the persistence of stools passing into the fistula, causing bacterial contamination and a local inflammatory reaction. We aimed to compare remission rates between patients treated by MSC injection with simple sutures and those treated with a rectal advancement flap. This single-center prospective study compared the first patients who underwent internal opening closure with sutures with the subsequent patients treated with a flap. Complete clinical remission was defined as complete closure of the external opening(s) without pain or discharge, and complete radiological remission was defined as a Magnifi-CD score of 0. We compared the first 42 patients who had sutures with the 20 subsequent patients who had an advancement flap. The median follow-up was 15.5 [8.8-24.9]months. The cumulative incidence of complete clinical response at M12 was 53.8% [38.1-69.6%] in the suture group versus 93.3% [77.4-100.0] in the flap group (p < 0.001). The Magnifi-CD score was 0 for 41.7% [25.5-59.2%]) of patients treated with sutures versus 72.7% [39.0-63.9%]) of patients treated with a flap (p=0.093). Anal incontinence score did not differ between the two groups. Practicing an advancement flap was the only significant factor associated with complete clinical remission over time (adjusted HR [95% CI] of 2.6 [1.4-4.9], p = 0.003). Complete clinical remission rates following MSC injection are significantly higher after closure of the internal opening with a rectal flap than after closure with sutures, without consequences on anal continence.

Objective Comparison of the First-Person-View Live Streaming Method Versus Face-to-Face Teaching Method in Improving Wound Suturing Skills for Skin Closure in Surgical Clerkship Students: Randomized Controlled Trial.

The use of digital online teaching media in improving the surgical skills of medical students is indispensable, yet it is still not widely explored objectively. The first-person-view online teaching method may be more effective as it provides more realism to surgical clerkship students in achieving basic surgical skills. This study aims to objectively assess the effectiveness of the first-person-view live streaming (LS) method using a GoPro camera compared to the standard face-to-face (FTF) teaching method in improving simple wound suturing skills in surgical clerkship students. A prospective, parallel, nonblinded, single-center, randomized controlled trial was performed. Between January and April 2023, clerkship students of the Department of Surgery, Pelita Harapan University, were randomly selected and recruited into either the LS or FTF teaching method for simple interrupted suturing skills. All the participants were assessed objectively before and 1 week after training, using the direct observational procedural skills (DOPS) method. DOPS results and poststudy questionnaires were analyzed. A total of 74 students were included in this study, with 37 (50%) participants in each group. Paired analysis of each participant's pre-experiment and postexperiment DOPS scores revealed that the LS method's outcome is comparable to the FTF method's outcome (LS: mean 27.5, SD 20.6 vs FTF: mean 24.4, SD 16.7; P=.48) in improving the students' surgical skills. First-person-view LS training sessions could enhance students' ability to master simple procedural skills such as simple wound suturing and has comparable results to the current FTF teaching method. Teaching a practical skill using the LS method also gives more confidence for the participants to perform the procedure independently. Other advantages of the LS method, such as the ability to study from outside the sterile environment, are also promising. We recommend improvements in the audiovisual quality of the camera and a stable internet connection before performing the LS teaching method.

Simple incision and suture modeling on fixed structured grids

This paper presents a simple yet versatile approach to simulate skin incisions and suturing using nonlinear finite element analysis on a fixed structured grid with a spring-based suture model. Incisions and wounds are introduced by element removal and the sutures are discretely modeled by applying linear constraint relations pairwise to groups of nodes. Two numerical examples utilize the closing of an elliptical wound to study the influence of the number of sutures and their location, and two test cases use the Z-plasty transposition flap technique to investigate the versatility of the proposed method and for comparison with state-of-the-art results. The results indicate that the presented method is able to recreate literature results to an acceptable level of accuracy. Further, the method proves versatile due to the ability to freely introduce incisions and wounds onto the fixed grid modeling domain without remeshing. Lastly, the two main advantages of the discrete suture representation are the ability to capture local stress concentrations near the sutures and the full freedom in placing the sutures.

Evaluation of the hinotori™ Surgical Robot System for accurate suturing in small cavities

The hinotori™ Surgical Robot System (hinotori™, Medicaroid, Kobe, Japan) is increasingly being utilized primarily in urology and adult surgery; however, data on its application in pediatric surgery are lacking. This preclinical study aimed to evaluate the limitations of this system for accurate suturing in small cavities designed for pediatric and neonatal applications. Two trained operators performed simple ligature sutures (easy task [ET]) and hepaticojejunostomy sutures (difficult task [DT]) within five differently sized boxes, ranging from 5123 to 125 mL. The suture time, number of internal and external instrument/instrument collisions, instrument/box collisions, and suture accuracy were evaluated. The suture accuracy was assessed using the A-Lap Mini endoscopic surgery skill assessment system. As a result, an increase in the number of collisions and extended suturing times were observed in boxes with volumes smaller than 215 mL. Despite these variations, there were no significant differences between the boxes, and all tasks were precisely performed in all boxes (p = 0.10 for the ET and p = 1.00 for the DT). These findings demonstrate the capability of the hinotori™ system to perform precise suturing techniques within tightly confined simulated neonatal cavities as small as 125 mL. To advance the integration of pediatric robotic surgery utilizing the hinotori™ system, additional trials comparing it with conventional laparoscopic and thoracoscopic techniques using pediatric and animal models are necessary to assess its clinical safety and applicability.

A Proposal for Modification of Ferguson's Closed Hemorrhoidectomy Technique Aiming Better Outcomes

AbstractMany technical propositions have been incorporated to the surgical management of hemorrhoidal disease during the recent decades. Besides that, escisional techniques are still considered the best option to control symptoms and reduce recurrence. The present manuscript aims to propose a technical modification of the classical closed hemorrhoidectomy described by Ferguson in America. Our proposition is to perform two sutures to close the wound resulting from hemorrhoidal resection. The first one consists of an anchored continuous suture using a very thin (4–0 or 5–0) monofilamentar thread coming from inside to the outside skin. After tying the stitch, a simple continuous second suture is made over the previous suture only for mucosal approximation, from outside to inside. Finally, the stich that initiated the first suture is tied up to the stich used for the second suture, and the knot remains located above the dentate line, not to disturb the patient. The confection of two layers aims to reinforce the closing of the wound and avoid dehiscence. The idea is that this modification influences postoperative outcomes by reducing symptoms such as wound discharge and pain, and thus improving healing and esthetics. In a next step research, a comparison with the classical technique may bring new insights to this issue.

Gastrojejunal-Colic Fistula of Ulcerative Origin: A Case Report

Gastrojejunocolic fistula was a frequent complication of surgery for peptic ulcer disease. Currently, it has become exceptional since the rarity of ulcer gastrectomies. Only 37 cases have been reported in the literature. The treatment of gastrojejunocolic fistula is surgical. It consists of a triple resection, gastric, jejunal and colonic, including the fistula. We report a case of gastrojejunocolic fistula, previously operated for perforated ulcer treated by simple suture with gastro-entero-anastomosis.

The Catheter Fell Out

BackgroundAccidental catheter removal or drain dislodgment, including tube thoracostomy, is a common, high-risk complication in hospitalized and ambulatory patients that often necessitates an additional procedure, increased length of stay, and increased cost. MethodsThe aim of this study was to compare the tensile strength of pigtail catheter fixation using a simple interrupted suture, a U-stitch suture, or 2 simple interrupted skin sutures in a standardized skin model. Catheters were sutured to the skin, penetrating the collagen layer, with 1 of the 3 suture techniques and varying suture combinations. ResultsFor each trial, breakage occurred at the suture or knot. The mean breakpoint varied significantly between 2 simple interrupted sutures and both the 1 simple interrupted suture and the U-stitch technique (analysis of variance post hoc test P < .001), with the 2 simple interrupted suture technique withholding nearly 40% more force. Using the strongest suture, 0 silk, on a deceased adult sheep to secure a pigtail thoracostomy catheter yielded identical data compared with the standardized skin model. ConclusionsIn conclusion, 2 simple interrupted skin sutures to secure a pigtail catheter has very low risk with a strongly positive benefit.

Commercial suture passer improves efficiency and ease of use versus conventional needle in minimally invasive thoracolumbar fascia closure: a cadaveric analysis

BackgroundLow-profile suture passers have been introduced to facilitate thoracolumbar fascia closure in minimally invasive spine (MIS) surgery. The purpose of this study was to evaluate the closure time of a modern suture passer to a conventional curved need for MIS fascia closure in a cadaveric model. MethodsSix clinicians specializing in orthopedic spine surgery were recruited for the study and randomly assigned 1 cadaveric torso. Subcutaneous tissue was resected at L4-L5, replicating MIS surgery, followed by placement of a 60×18-mm or 100×18-mm tubular retractor for access. Clinicians were required to close the fascia with three unknotted, simple interrupted sutures using a swaged curved needle or suture passer (Spine Scorpion™, Arthrex, Inc., Naples, FL). The completion time was recorded, starting immediately before suturing and ending after the last pass. A time cutoff of 10 min was implemented in consideration of reasonable operating room time, and the number of achieved suture passes (of 6) were recorded. Clinicians were asked to qualitatively grade ease of use in relation to prior fascial closure experience per a 0-5 scale, where 0 is impossible and 5 is easiest. ResultsThe mean change in fascial closure completion time (Δ) was significantly reduced with the Spine Scorpion compared to the curved needle with the 60×18-mm retractor (Δ=5.80 min; 95% CI, 2.92-8.67 min; p=.004) and 100 × 18-mm retractor (Δ=5.28 min; 95% CI, 2.76-7.80 min; p=.003). Full closure was achieved within the time limit for all trials of the Spine Scorpion, while the standard needle achieved full closure in 67% (4 of 6) and 50% (3 of 6) of trials with the 60 × 18-mm and 100×18-mm retractors, respectively. Median ease-of-use scores with the 60×18-mm and 100×18-mm retractors, respectively, were 4.5 (range, 4-5) and 4.5 (range, 3-5) for the Spine Scorpion, and both 1.0 (range, 1-2) for the curved needle. ConclusionResults from this laboratory investigation using a suture passer for thoracolumbar fascia closure show a significant reduction in closure time and completion of the procedure compared to a conventional curved needle.

Ex-vivo biomechanical evaluation of the application of a novel annulus closure device to closure of annulus fibrosus.

To investigate the technical feasibility of applying a simple suture guide device to close the annulus fibrosus (AF) of the intervertebral discs (IVD). 30 sheep functional discal units (FDUs) were obtained and subjected to mock discectomy. Mock sutures were performed using 3-0 non-absorbable sutures under a novel AF suture device following a suture procedure. The FDUs were compressed under axial loading at 1.8mm/min and evaluated for Failure load (N). The failure loads of the hand stitching group (Group H) and suture device stitching group (Group S) were significantly higher than those of the control group (Group C) (p = 0.033; p < 0.001). This study provides reasonable reasons to believe that the simple suture guide device described here is technically feasible for AF defect closure. It thus constitutes an encouraging proof of concept for the proposed device; however, it does not constitute a complete demonstration of the device's feasibility in the clinical setting considering that the annulus closure operation is performed ex vivo on functional spinal units, as opposed to within an environment that mimics the clinical setting. To this end, confirmatory experiments will be conducted such as more multiaxial or dynamic mechanical testing, and notably performing the surgery on sheep models instead of on ex vivo functional spinal units.

The Direct Tendon Suture and Paratenon Repair Technique for Acute Tendinous Mallet Finger: A Case Series.

(1) Introduction: Tendinous mallet finger is a frequent deformity that occurs after an extensor tendon injury during sports or daily life activities. Despite the existence of numerous non-operative and operative techniques to address this deformity, there is a controversy on its optimal management. In this study, we aimed to present a direct tendon suture technique using the distal interphalangeal (DIP) joint open approach for treating tendinous mallet finger injury. (2) Methods: Between 2019 and 2021, 19 patients with closed non-fracture tendinous mallet fingers underwent the direct tendon and paratenon repair technique. After skin incision, we opened the paratenon with lazy S shape incision and found the ruptured proximal and distal tendon ends. We reapproximated the tendons using a simple interrupted suture with Prolene #6/0. After that, we meticulously performed paratenon repair using PDS #6/0 for preventing readherence. Temporary trans-articular Kirschner wire fixation was used for 4 weeks. (3) Results: All patients were followed-up for 3-8 months (mean: 4.8 months). The mean final extension lag was 6.5 degrees, and the overall rate of cases with excellent and good outcomes using Crawford's criteria was 85%. (4) Conclusions: In conclusion, this surgical approach could be a reliable alternative for the treatment of tendinous mallet finger injuries.