Open Reduction and K-Wire Fixation for Mallet Finger Fractures

PURPOSE: To evaluate the results of open reduction and K-wire fixation in patients with a displaced dorsal intraarticular fracture of the distal phalanx. MATERIALS AND METHODS: From May 1999 through April 2008, 32 fingers (32 patients) with a mallet finger fracture involving one-third or more of the articular surface and/or a subluxated distal phalanx were included. While maintaining the reduction of the dorsal fracture fragment obtained by open method, two K-wires were introduced to fix the fragments and the third K-wire to fix the distal interphalangeal joint. Clinical results were investigated at an average follow-up of 13 months. RESULTS: Radiologically, solid bony union was observed in all fingers at an average of 6.5 weeks after the operation. The final results showed exellent in 17 patients(53.1%), good in 14 patients(43.8%) and fair in one(3.1%) according to the criteria suggested by Crawford. CONCLUSION: Open reduction and K-wire fixation of the displaced bony mallet fractures is considered as an acceptable surgical method in providing successful bony union and maintenance of joint motion.

Treatment of the Totally Displaced Supracondylar Fracture of the Humerus in Children by Three Crossed K-Wires Fixation / 대한정형외과학회잡지

Forty children underwent three crossed K-wires fixation after reduction of the totally displaced supracondylar fracture(type IE ) of the humerus from October 1994 to March 1997, were reviewed. The patients age ranged from 3 years and 2 months to 12 years and 7 months, averaging 6 years and 6 months. Preoperatively, five patients(12.5%) had concomitant nerve injury. Three patients(7.5%) revealed ischemic sign on distal part of the fracture. All the fractures were treated within 24 hours after arrival at the emergency room. After general anesthesia, all but one fractures reduced by closed means. Each reduced fracture was fixed by two parallel K-wires in lateral side followed by one crossed medial K-wire under fluoroscopic control. The preoperative distal ischemia of the three patient restored blood supply within 24 hours after reduction. The K-wires were removed after averaging 3.3 weeks after operation in out patient clinic. Five patients revealed neurologic deficit preoperatively recovered completely within 4 months after reduction of the fractures. The followup period ranged from 12 months to 32 months, averaging 17 months. By Flynns functional and cosmetic criteria, 39 patients(97.5%) among forty patients resulted in satisfactory criteria. The one unsatisfactory patient revealed cubitus varus treated by corrective osteotomy. In conclusion, three crossed K-wires fixation is considered as effective and safe method for the totally displaced supracondylar fracture of the humerus in children.