Extension block and direct pinning methods for mallet fracture: A comparative study

Han, Hyun Ho; Cho, Hyun Jun; Kim, Seong Yeon; Oh, Deuk Young

doi:10.5999/aps.2017.01431

Cited by 9 publications

(8 citation statements)

References 23 publications

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“…Also, in the investigation of Han et al, 10 Our results were in agreement with study of Çapkın et al, 11 as they reported that no any complications were found, like the fracture fragmentation, nail deformation, volar subluxation, or dislocation or DIP joint osteoarthritis. 2-patients advanced surface infections, and one patient advanced skin necrosis; all of them were managed with oral anti-biotics and wound care, if required.…”

Section: Resultssupporting

confidence: 91%

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Extension Block Technique in Management of Mallet Finger

Ibrahim

Shamma

Elghany

2021

Al-Azhar International Medical Journal

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Background: Mallet finger is one of the most frequent fingertip injuries that is made by trauma to the terminal inserting of the extensor digitorum tendons. It frequently happens throughout sport activity, while it could as well happen throughout every day activity. Aim of the work: to evaluate the functional outcome of the extension block fixation of mallet fructure. Methods: Prospective randomized study. The study had been carried out in orthopedic Surgery departments in Al-Azhar University (Cairo). This study had been conducted on 30 patients of both sex and age ranging between 20 and 50-yrs old. Result: IIB was the predominant classification in 63.3% of the patients, IIC was found in 26.7%, IB was found in 6.7% and only one patient was IC. The mean operative time was 35.72 ±10.09 min and mean hospital time 1.19 ± 0.349 day. Regarding outcomes, 10 (33.3%) patients were excellent, 16 (53.3%) patients were good, 3 (10%) patients were fair and 1 (3.3%) case was poor. Conclusion: Extension block pinning is a simple and effective treating modality for mallet fractures when performed correctly. It provides excellent functional outcome in acute and sub-acute presentations. It also gives the advantage of treating the fracture as a day care procedure with minimal instruments and no post-operative scars.

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Section: Resultssupporting

confidence: 91%

“…Furthermore, Han et al, 10 demonstrated that a number of 41-cases (29-men and 12-women) have involved in the current work, with ages mean of 36yrs (between, 15 and 62-yrs).…”

Section: Resultsmentioning

confidence: 81%

Extension Block Technique in Management of Mallet Finger

Ibrahim

Shamma

Elghany

2021

Al-Azhar International Medical Journal

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“…Additionally, very few studies in the literature have directly compared EBT with HPT; all of these comparative studies have small sample sizes. [ 18 , 27 , 29 ] A comparison of the longterm results of EBT with HPT would be a valuable contribution to the literature. Of note, all patients in the current study regained most of their functions at the end of the third month.…”

Section: Discussionmentioning

confidence: 99%

A new custom-made plate preparation method for bony mallet finger treatment and a comparison with extension block technique

et al. 2021

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Objectives In this study, we aimed to describe a new hook plate technique (HPT) and to compare our results with the conventional extension block technique (EBT) with a Kirschner wire (K-wire) for bony mallet finger treatment. Patients and methods Between April 2015 and January 2018, a total of 19 patients including 10 who were treated with EBT (7 males, 3 females; mean age: 30.1±7.3 years; range, 17 to 48 years) and nine who were treated with HPT (6 males, 3 females; mean age: 31.7±11.3 years; range, 19 to 42 years) for bony mallet finger with distal interphalangeal (DIP) joint subluxation and/or fracture fragment larger than one-third of distal phalanx (Wehbe-Schneider type 1/b, 2/a, 2/b, 3/a) joint were retrospectively analyzed. The DIP range of motion (ROM), Warren and Crawford scores, time to return to work/daily activity, operation time, the number of fluoroscopy shots, cost and complications were compared. Results No significant difference was found in the DIP ROM (p=0.708) and the Warren/Norris and Crawford scores (p=0.217 and p=0.175, respectively) between the two groups. Operation time and material cost were higher with HPT (p=0.006, p=0.001). There was no significant difference in the number of fluoroscopy shots (p=0.344). Although DIP joint motion was started at two weeks in the HPT group and at eight weeks in the EBT group, no significant difference was observed in the time of return to work and normal daily life in both groups (p=0.859). Complications were observed in two patients in the EBT group and in three patients in the HPT group. No significant difference in total complications was observed between the two groups (p=0.666). Conclusion Bony mallet finger treatment with a custom-made hook plate prepared from 1.3-mm AO plates appeared to be clinically and radiologically similar to EBT. Additionally, HPT had the advantages of allowing early ROM to DIP joint and eliminating the need for a secondary surgery such as K-wire removal. On the other hand, hardware cost with HPT was higher than EBT.

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“…Yamanaka and Sasaki[ 30 ] used one or two compression pins to fix the dorsal fragment to the distal phalanx in 15 patients and obtained good results with 1 degree of hyperextension to 60 degrees of flexion. Also, Han et al[ 31 ] compared DBP and direct pinning and found that direct pinning was superior to DBP in terms of improvement in extensor lag and ROM; however, both groups achieved good results according to the Crawford criteria. In our practice, we prefer the direct pinning technique of Badia and Riano,[ 19 ] when the fragment size is close to 50% of the joint surface, since it provides straightforward reduction of the DIP joint.…”

Section: Discussionmentioning

confidence: 99%

The results of delayed open reduction and internal fixation in chronic bony mallet finger injuries

Yıldırım¹,

Kayalar²,

Ozaksar³

et al. 2021

Jt Dis Relat Surg

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Objectives The aim of this study was to evaluate the functional results of delayed open reduction and Kirschner wire (K-wire) fixation procedures in patients with delayed presentation of bony mallet finger. Patients and methods Between February 2009 and November 2019, a total of 19 patients (15 males, 4 females; median age: 24.8 years; range, 14 to 47 years) who were diagnosed with a delayed bony mallet finger and treated with dorsal block pin, direct pinning, or the umbrella handle technique were retrospectively analyzed. The Crawford criteria were used to evaluate the outcomes. The degrees of range of motion (ROM) were measured by a goniometer. Results The median time from injury to surgery was 41 (range, 28 to 90) days. The median DIP joint extension limitation was 7.63 (range, 0 to 40) degrees and the median ROM of the DIP joint was 66.3 (range, 20 to 90) degrees. There was no statistically significant difference in the postoperative ROM, compared to the uninjured side (p>.05). The Crawford score was excellent in 11, good in four, fair in three, and poor in one patient. Bone union was achieved in all patients. Conclusion Delayed open reduction and K-wire fixation of chronic bony mallet finger injuries yield successful functional outcomes with low complication rates. Extension lag can be eliminated in most patients by making the joint surface anatomical. The most optimal method should be selected depending on the size of the fracture fragment.

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Extension block and direct pinning methods for mallet fracture: A comparative study

Cited by 9 publications

References 23 publications

Extension Block Technique in Management of Mallet Finger

Extension Block Technique in Management of Mallet Finger

A new custom-made plate preparation method for bony mallet finger treatment and a comparison with extension block technique

The results of delayed open reduction and internal fixation in chronic bony mallet finger injuries

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