Pull-In Suture Technique for the Treatment of Mallet Finger

Abstract

The pull-in technique allows accurate realignment of the tendon-bone unit without any specific instrumentation or intraoperative fluoroscopic imaging methods.

Treatment Options for Mallet Finger: A Review

“…Overzealous distal soft-tissue dissection may also cause nail plate deformities and skin flap necrosis. 35,38 Other techniques that also shorten the terminal extensor tendon are plication of the elongated tendon, 6 reinsertion of the tendon with a Mitec microbone anchor 41 or pull-through suture, 42 and repair with a tendon graft. 43 The aim of tenotomy of the central slip is to rebalance the extensor mechanism by transecting the insertion of the central slip, thereby transmitting increased extensor force and excursion to the terminal tendon.…”

A New Treatment Modality for Mallet Finger Deformity: 4-2-2 Protocol

“…Ulusoy ve ark. 'da (5) kemik ve tendon bütünlüğünün restorasyonu amacıyla pull-in sütür prosedürünü tanımlamışlardır. Bu teknikte, açık redüksiyon ve kirschner teli ile sabitleme sonrasında terminal tendondan Kessler tekniğine uygun şekilde prolen sütür geçilmiş ve parmak pulpasına gömülmüştür.…”

“…Açık redüksiyon ve kirschner teli ile fiksasyon, gerilim bant teli, vida ile sabitleme, perkütan pin sabitleme, perkütan ekstansiyon blok pinleme, mini eksternal fiksatörler, pull in dikiş ve modifikasyonları gibi birçok değişik teknik klinik uygulamada kullanılabilmektedir. Her ne kadar birçok değişik teknik tanımlanmışsa da herkes tarafından kabul görmüş, tercih edilen bir teknik halen mevcut değildir (5)(6)(7)(8)(9)(10)(11)(12)(13)(14) .…”

Intraosseous suture technique with K-wire stabilisation for fixation of mallet fracture with DIPJ volar subluxation

“…6,13,26 Even suture anchors have been used. The technique that comes closest to ours is that is used by Ulusoy et al 13 Bauze and Bain have also used a technique of a suture; their suture is also trans-osseous but goes around the extensor insertion to act more like a tension band concept. 6 We utilise a full interosseous suture technique with the ability to get a perfect reduction and a stable fixation.…”

“…Surgeons have utilised various techniques including internal fixation, 5,6,8,9,[11][12][13][14][18][19][20][21][22][23][24] external fixation 25 and various suture techniques. 6,13,26 Even suture anchors have been used. The technique that comes closest to ours is that is used by Ulusoy et al 13 Bauze and Bain have also used a technique of a suture; their suture is also trans-osseous but goes around the extensor insertion to act more like a tension band concept.…”