Clinical comparison of hook plate fixation versus extension block pinning for bony mallet finger: a retrospective comparison study

Abstract

The aim of this retrospective study was to determine whether traumatic mallet fractures had better outcomes when treated by hook plate fixation (13 patients) or extension block pinning (19 patients). We assessed outcomes using Crawford's criteria; distal interphalangeal joint range of motion; the DASH score; and a visual analogue scale score for pain. We measured radiological parameters. No significant differences were observed in functional and clinical outcomes and in complications. Whereas the operative time was longer in the hook plate group, intraoperative fluoroscopy use, time to bone union and time to return to work were greater in the extension block group. Although the hook plate method is more technically demanding, it provides good stable reduction, earlier mobilization and an earlier return to work. The extension block pinning technique is easier and as effective but it requires greater peri-operative fluoroscopy. Level of evidence: Level III.

A comparison of delta wire technique versus extension block pinning in the treatment of bony Mallet finger

“…In terms of active DIPJ flexion, our study results were comparable with that in previous studies, which reported mean active flexion of 61° to 73° following extension block pinning, with mean follow up period of 11.9 to 34 months [8,13,16]. Patients in group 1 returned to their full occupational capacity significantly shorter than that in group 2.…”

“…This significant loss of extension explains the lack of excellent results according to Crawford criteria in group 1 patients. In comparison, all 11 patients in group 2 achieved excellent or good results, which is comparable to the 64 % to 94 % results reported in previous studies [8,[13][14][15].…”

“…However, there are some potential complications. The wires can potentially damage the articular cartilage, causing painful osteoarthritis of the DIPJ [13]. In addition, the duration of immobilization of the DIPJ in extended position leads to stiffness of the joint even after removal of the wire [14], necessitating additional physiotherapy sessions and delaying the time to return to work.…”

“…This is attributed to the additional amount of time required for physiotherapy as patients in group 2 suffered more stiffness after removal of K-wires. Acar et al [13] reported time to return to work at mean of 5.5 weeks with open surgery using hook plate and 6.7 weeks with percutaneous surgery using the extension block technique.…”

Comparison Between Y- and S-Shaped Incisions for Open Reduction and Hook-Plate Fixation of the Mallet Finger

“…There are several surgical techniques in the treatment of mallet finger such as repair using micro-screws, Kirshner wire pinning, and hook-plate, external fixator or button application (11)(12)(13)(14)(15)(16)(17). Surgical treatment has advantages in terms of early postoperative mobilization of fingers and early return to work.…”