Distal interphalangeal Joint Arthrodesis using only Kirschner Wires in small distal Phalanges

Lee, Jun-Ku; Lee, Soonchul; Choi, SeongJu; Han, Dong Hun; Oh, Jongbeom; Kil, Minkyu; Han, Soo-Hong

doi:10.1055/a-1559-2684

Cited by 6 publications

(4 citation statements)

References 24 publications

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“…The treatment of the bony mallet finger should restore the anatomy of the DIP joint by repositioning and fixing the avulsion fracture firstly, and secondly maintain the stability of the DIP joint by resisting the strong finger flexion forces ( 9 , 10 ). The “Ishiguro method” requires fixation of the DIP joint with a wire, which can cause damage to the articular surface and complications such as nail deformity and joint stiffness ( 11 , 12 ). We have modified the “Ishiguro method” and designed it.…”

Section: Discussionmentioning

confidence: 99%

New technique for the treatment of fresh bony mallet finger: A retrospective case series study

Zou

Mo²,

Xiong³

et al. 2023

Front. Surg.

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BackgroundThe bony mallet finger is a tear fracture of the extensor tendon, resulting in a flexion deformity of the finger, which affects both the function of the finger. The classical Ishiguro's method is associated with damage to the cartilage of the distal interphalangeal (DIP) joint and always lead to the joint stiffness. This paper explores a new technique to overcome the shortcomings of the classical Ishiguro's method and achieve better clinical efficacy.MethodsWe examined 15 patients with bony mallet fingers, 9 males and 6 females, from February 2020 to June 2022, ranged from 23 to 58 years, including 1 case of index finger, 5 cases of middle finger, 3 cases of ring finger and 6 cases of little finger. The median course of the injury to surgery was 2 days (range, 1∼7 days). All had fresh closed injuries, according to the Wehbe and Schneider classification: 4 cases of type IA, 6 cases of type IB, 3 cases of type IIA and 2 cases of type IIB. All patients were treated surgically by the new technique. Post-operative follow-up was conducted to record the healing of the fracture, the pain of the affected finger and the function of joint movement.ResultsThe 15 cases were followed up after surgery. The median active range of motion was 65° (range, 55∼75°). The median extension deficit of DIP joint was 0° (range, 0∼11°). The median clinical healing time of the fracture was 6 weeks (range, 6∼10 weeks). None of the patients experienced significant pain. The patients were assessed according to the Crawford criteria at the final follow-up: 11 cases were assessed as excellent, 3 cases were assessed as good and 1 case was assessed as fair. No loss of fracture repositioning, loosening of internal fixation, skin necrosis or infection was observed.ConclusionThe application of the new technique for the treatment of bony mallet fingers has the advantages of good stability, fracture healing and functional recovery of the DIP joint, making it an ideal surgical procedure for the treatment of fresh bony mallet fingers.

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Section: Discussionmentioning

confidence: 99%

New technique for the treatment of fresh bony mallet finger: A retrospective case series study

Zou

Mo²,

Xiong³

et al. 2023

Front. Surg.

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“…8) [46]. 주로 배측으 로 접근하여 원위 지관절을 절제한 뒤 유합되는 양측 면의 접촉면을 충분히 한 상태에서, K-강선, 무두 나사(headless screw), 와이어 등 을 이용하여 관절을 고정한다 [47,48].…”

Section: 성인 골성 추지unclassified

Current concepts in traumatic mallet finger management

Lee¹,

Kang²,

Park³

2023

Arch Hand Microsurg

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Mallet finger deformities can be divided into tendinous deformities caused by tendon rupture and bony deformities caused by fracture. In many cases, conservative treatment is possible. The goal of treating traumatic mallet finger deformities is to accurately restore the ruptured tendon or fractured bone to its proper position, correct extension lag or flexion contracture, prevent joint arthritis, and restore the full range of motion through appropriate range of motion exercises at the right time. In cases of tendinous mallet finger, immobilization with a splint or cast for at least 6 weeks in the extended position is required. During this period, flexion at the distal interphalangeal joint should be strictly limited, while movement at the proximal interphalangeal joint is allowed. Patient compliance with the protocol is essential for achieving good treatment outcomes. If conservative treatment fails or if the deformity recurs after initial surgery, satisfactory results can be achieved through tenodermodesis surgery. If the bony mallet finger involves a bone fragment of 3 mm or more or subluxation of the distal phalanx, surgical treatment is recommended. The primary surgical treatment involves closed reduction and percutaneous pinning with the extension block technique.

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“…Arthrodesis is the most common surgical treatment for terminal distal interphalangeal joint (DIPJ) arthritis, joint subluxation, and deformity [1][2][3]. Traditional approaches for a DIPJ include a transverse, H, Y, and lazy S style incisions around the dorsal aspect of DIPJ followed by a dorsal capsulotomy [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Surgical Outcomes of Smile Incision and Reverse Shotgun Technique for Distal Interphalangeal Joint Arthrodesis

Chiang

Hsu

Shaw

et al. 2023

Preprint

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Background Arthrodesis serves as the traditional therapeutic approach for advanced distal interphalangeal joint (DIPJ) arthritis. However, the conventional technique may prove insufficient when the excision of pronounced volar and lateral spurs is required. To address this, we innovated the 'smile incision with reverse shotgun approach'. This method enhances joint exposure and yields superior cosmetic results by extending the transverse skin incision over the DIPJ and cleaving the accessory collateral ligament, thereby improving access to the volar and lateral joint margins. This article meticulously elucidates the surgical procedure and presents preliminary results of its implementation. Method The clinical data of 22 consecutive patients (36 fingers) who received DIPJ arthrodesis by this procedure during March 2018 to October 2022, with a mean follow-up period of 9.8 months, were reviewed. Patients’ demographics, union rate, complications, radiographic findings, as well as visual analogue scale (VAS) for pain and satisfaction, were collected and analyzed. Results Thirty-five of 36 fingers achieved uneventful bony union (97.2%). The average VAS for pain and satisfaction as well as he coronal plane deviation of DIPJ significantly improved after the operation (all, P < 0.05). No skin necrosis, nail deformity, or infection were observed during the follow-up period. Conclusion The smile incision and reverse shotgun approach provided excellent DIPJ exposure, high union rate, and cosmetic appearance for DIPJ arthrodesis surgery. This technique may be a good surgical option for DIPJ arthrodesis when more volar part joint preparation and more volar implant insertion sites are necessary.

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Distal interphalangeal Joint Arthrodesis using only Kirschner Wires in small distal Phalanges

Cited by 6 publications

References 24 publications

New technique for the treatment of fresh bony mallet finger: A retrospective case series study

New technique for the treatment of fresh bony mallet finger: A retrospective case series study

Current concepts in traumatic mallet finger management

Surgical Outcomes of Smile Incision and Reverse Shotgun Technique for Distal Interphalangeal Joint Arthrodesis

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