Derotation of the mallet piece: A crucial point in mallet fracture surgery

Karslıoğlu, Bülent; Uzun, Metin; Tetik, Cihangir; Tasatan, Ersin; Tekin, Ali Çağrı; Büyükkurt, Cem Dinçay

doi:10.1016/j.hansur.2018.03.004

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…Karslıoğlu et al [24] emphasized that rotation of the mallet fragment can prevent appropriate fracture reduction and may result in extension lag, incongruity of the articular surface, premature osteoarthritis, or stiffness. They described a percutaneous derotation technique utilizing needle-tip reduction during surgery for type IIb and IIIc patients according to the Wehbe and Schneider classification.…”

Section: Discussionmentioning

confidence: 99%

“…[25] They found that derotation of type II (25% rotation) and III (50% rotation) mallet pieces with closed reduction was simple, effective, and could prevent surgical failure. [24] The transfixation K-wire was used as in the original extension-block technique. The technique presented in the current study was not used in the presence of rotational deformity.…”

Section: Discussionmentioning

confidence: 99%

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Extension-block pinning to treat bony mallet finger: is a transfixation pin necessary?

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BACKGROUND: Extension-block pinning is a popular treatment for mallet fractures, but it is associated with several pitfalls. Of note, transfixation Kirschner wires used to fix the distal interphalangeal (DIP) joint may cause iatrogenic nail bed injury, bone fragment rotation, chondral damage, or osteoarthritis. The objective of this study was to determine whether a transfixation pin was necessary for extension-block pinning in the treatment of bony mallet fracture. METHODS:Patients were treated with a pin-orthosis extension-block technique if they had been diagnosed with a type IVB mallet fracture according to Doyle's classification. Radiological outcomes were evaluated based on postoperative X-ray results, and functional outcomes were evaluated using Crawford's criteria. RESULTS:Thirteen patients (9 males and 4 females) with a mean age of 26 years were included. The mean time between the injury and surgery was 3.3 days, and the mean follow-up period was 8.2 months (range: 4-12 months). Radiographic bone union was achieved in all patients within an average of 5.1 weeks (range: 5-6 weeks). At the final follow-up, the DIP joint had an average degree of flexion of 76.1° (range: 65°-80°) and an average extension deficit of 3.84° (range: 0°-15°). According to Crawford's criteria, 8 patients had excellent results, 4 patients had good results, and 1 patient had a fair result. No patient reported pain at the final follow-up. CONCLUSION:Satisfactory clinical and radiological outcomes were obtained with the pin-orthosis extension-block technique. Future prospective and randomized studies are justified to confirm the efficacy of this technique.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%