Prognostic Factors of the Extension Block Technique for the Bony Mallet Finger / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the clinical results and prognostic factors of the extension block technique for treating a bony mallet finger. MATERIALS AND METHODS: Between July 2002 and January 2009, forty-nine patients who underwent the extension block technique for a bony mallet finger were evaluated. The minimum period of follow up was 6 months. The type of fracture was classified by the Wehbe and Schneider method. The results were evaluated by the Crawford classification. The prognostic factors were analyzed according to age, gender, the timing of the surgery, the mallet fragment angle and the residual displacement. RESULTS: According the Crawford classification, there were 22 excellent, 20 good, 6 fair and 1 poor results. The poor prognostic factors were an older patient age, subluxation, a smaller mallet fragment angle and smaller postoperative displacement (p<0.05). CONCLUSION: The prognostic factors of the extension block technique for bony mallet finger were the patient age, subluxation, the mallet fragment angle (more than 30 degrees) and the postoperative displacement.

Modified Extension Block Technique Using Conjoined Kirschner Wires for Bony Mallet Fingers

PURPOSE: To analyze the clinical results of the modified extension block fixation method using conjoined K-wires for bony mallet fractures. MATERIALS AND METHODS: From March 2006 to March 2009, we performed conjoined K-wire fixation as a modification of extension block technique in 9 patients with a bony mallet finger. After the average follow-up of 4.8 months, range of motion, pain, nail deformity, and bony union were evaluated. RESULTS: The average range of motion was 3.3degrees (range, 0-20degrees)of extension lag and 76.7degrees (range, 45-90degrees) of flexion. Bony union was obtained in all patients. No nail deformity was observed. One patient complained of distal interphalangeal joint pain. CONCLUSION: The extension block fixation method using conjoined K-wires can be an acceptable treatment option which provides stable fixation in bony mallet fractures.

Modified Extension Block Technique for Large Mallet Fracture

PURPOSE: To evaluate retrospectively the clinical results of modified extension block technique for large mallet fracture. MATERIALS AND METHODS: From May 2006 to August 2007, we reviewed 16 patients who got surgery with large mallet fracture. Surgical indications included fractures involving more than 33% of the articular surface or fractures associated with subluxation of the distal interphalangeal joint. The average age was 32.6 years old. The average time from injury to surgery was 10days. We performed modified extension block technique in all patients. The pins were removed between 5 to 6 weeks when we confirmed bone union by radiology. Function outcomes were determined by using the Crawford criteria. RESULTS: The average fracture fragment size was 52% of the joint surface. Average time to fracture union was 5.4weeks(4.5~7.5weeks). At a mean follow-up of 8.2months(5-13months) average extension loss was 3degrees (0-10degrees )and average flexion was 77degrees (60-85degrees ). According to Crawford classification, 81.3% of paitents had excellent or good results. There were 2 nail deformity. CONCLUSION: Modified extension block technique can make up for the weak points of traditional techique in the treatment for large mallet fracture.

Treatment of Mallet Finger Fracture by Extension Block K-wire Fixation / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the outcomes of the extension block fixation technique for a bony mallet finger. MATERIALS AND METHODS: Thirty-five patients that received extension block fixation for bony mallet finger were enrolled in this study between July 2001 and October 2005. The fracture type was classified by the Wehbe and Schneider method. The average follow up period was 15 months, ranging between 12-52 months. The results were classified by the Crawford criteria. RESULTS: There was 30 cases of type I, 5 cases of type II and no cases of type III, with 11 cases of subtype A, 22 cases of subtype B, and 2 cases of subtype C. The average time from injury to operation was 12 days, which included three cases of over 28 days. The K-wire was removed 30 days after the operation, and joint exercises were initiated immediately. There were 10 cases with excellent outcomes, 18 cases with good outcomes, 4 cases with fair outcomes, and 3 cases with poor outcomes. The poor outcome had complications such as subluxation of the DIP joint, lag between injury to operation time (more than 4 weeks), and more than 1 mm displacement. CONCLUSION: The extension block technique for the treatment of bony mallet finger is relatively simple and results in satisfactory bone union.

The Result of the Modified Extension Block Technique in Bony Mallet Finger

PURPOSE: To evaluate the treatment outcomes of the modified extension block technique for bony mallet finger. MATERIALS AND METHODS: This study included 16 patients who had been treated with the modified extension block technique for bony mallet finger from December 2002 to January 2004. The average duration of follow up was 13 (12~17) months. The indication of operation was the presence of a large bony fragment invading more than 1/3 of the articular surface or the palmar subluxation in the distal interphalangeal joint. RESULTS: The average extension lag was 2.3 degrees, and the range of motion of the distal interphalangeal joint was 68.8 degrees. Radiograph showed bony union state in all cases. By the Crawford's evaluation criteria, 12 cases (75%) was excellent or good. Postoperative complications occurred in 3 cases, which were reduction loss within postoperative 2 weeks in 2 cases and mild pain with motion in 1 case. CONCLUSION: The modified extension block technique is a easy and simple method. It shows a good result without complications from skin incision. So, it seems a useful method for bony mallet finger.