Temporary Kirschner wire fixation for a mallet toe of the hallux

Nakamura, Satoru

doi:10.1007/s00776-006-1106-x

Cited by 18 publications

(28 citation statements)

References 8 publications

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“…Simple axial Kirschner wire fixation can not firmly fix the broken ends and allows poor anti-rotation ability. This may increase the risk of delayed healing and nonunion of the fractures, while cross Kirschner wire fixation avoids anatomical reduction due to the narrow section of the distal phalangeal bone, which increases the difficulties and the time of operation, further damaging the distal blood supply [10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Self-made adjustable external fixation device with progressive compression for the management of open fracture with bone defects of the distal hallux phalanx: a case report

Ying-guo¹,

Tong²,

Liu³

2020

Preprint

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Background: Open fractures with bone defects of the distal phalanx of the hallux are both rare and complicated, and these conditions pose great clinical challenge to orthopedists as improper handling can lead to distal tissue necrosis, osteomyelitis, malunion, non-union and even amputation. Due to the lack of soft tissue and bone and the blocking effect caused by un-disconnected soft tissue, it is relatively difficult to achieve effective reduction and fixation of the fracture by traditional methods. Methods: we present a patient, diagnosed with open fracture combined with bone defects of the distal segment of the great toe, who was treated using a self-made adjustable external fixation device by complete debridement, effective closed reduction and continuous adjustment. Complications were registered and clinical outcome was measured at the follow-up periods. Results: The device was simple to make with a low cost and practicality, and this technique resulted in effective maintenance of reduction and progressive compression in the fracture ends. The patient finally obtained optimal fracture healing and satisfactory function of the injured toe at last follow-up. Conclusions: The selfmade adjustable external fixation device is reliable in maintaining reduction and fixation, which provides an alternative for the management of open fracture associated with bone absence of the distal phalanx of the hallux.

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Section: Discussionmentioning

confidence: 99%

Self-made adjustable external fixation device with progressive compression for the management of open fracture with bone defects of the distal hallux phalanx: a case report

Ying-guo¹,

Tong²,

Liu³

2020

Preprint

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“…Surgical treatment with Kirschner wires was described by three authors [5] [6] [7]. Nakamura reported a case treated with temporary interphalangeal joint fixation using a Kirschner wire after failed conservative treatment due to continued swelling and difficulty in maintaining the fragment in a reduced position [5].…”

Section: Discussionmentioning

confidence: 99%

“…case treated with open reduction and fixation using two Kirschner wires and temporary interphalangeal joint fixation after failed percutaneous treatment [7]. These three case reports showed good clinical results, but the temporary transarticular fixation of the interphalangeal joint with a Kirschner wire and care of the surgical site for a few weeks is inevitable [5] Hong et al reported two cases treated with a suture anchor for reattaching the avulsed fragment without transarticular immobilization of the interphalangeal joint [8]. They reported that a suture anchor was inserted into the fracture bed of the distal phalanx and two drill holes were made into the avulsed fragment.…”

Section: Discussionmentioning

confidence: 99%

“…It is a rare injury and its treatment has been reported only in six case reports [1] [4] [5] [6] [7] [8]. These treatments included conservative therapy with a splint to prevent plantarflexion of the hallux [1] [4], Kirschner wire fixation similar to that in bony mallet finger [5] [6] [7], or open reduction and internal fixation with a suture anchor [8]. It is difficult to immobilize the interphalangeal joint in extension with a splint unlike in the mallet injury of the finger [5].…”

Section: Introductionmentioning

confidence: 99%

“…These treatments included conservative therapy with a splint to prevent plantarflexion of the hallux [1] [4], Kirschner wire fixation similar to that in bony mallet finger [5] [6] [7], or open reduction and internal fixation with a suture anchor [8]. It is difficult to immobilize the interphalangeal joint in extension with a splint unlike in the mallet injury of the finger [5]. Kirschner wire fixation tends to be less invasive but temporary interphalangeal joint fixation is inevitable, though joint stiffness, osteoarthritis, and infection due to temporary fixation may be rare…”

Section: Introductionmentioning

confidence: 99%

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Mallet Toe of the Hallux Treated by Bridging Suture Technique Using Suture Anchors: A Case Report and Literature Review

Ando¹,

Kobayashi²,

Koide³

et al. 2019

OJO

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An avulsion fracture of the extensor hallucis longus at the distal end of the great toe is called "mallet toe" of the hallux. It is a rare injury and the treatment options are conservative treatment using a splint, percutaneous or open Kirschner wire fixation similar to that in the mallet finger, or suture anchor fixation. We present a case treated by the bridging technique using two suture anchors. A 57-year-old Japanese man injured his left great toe after a fall while walking barefoot on the bed. His great toe was forced into a hyperplantarflexion position. Plain radiography and computed tomography showed a small bone fragment at the base of the dorsal distal phalanx, suggesting an avulsion fracture of the extensor hallucis longus. He was treated by bridging suture technique with two suture anchors. At first, two suture anchors were inserted to the fracture bed of the distal phalanx, and then the bone fragment and extensor hallucis longus tendon were secured with two horizontal mattress sutures. Finally, bridging sutures were performed using the remaining sutures and the sutures used for mattress suturing. He obtained bony union and symmetric range of motion of the interphalangeal joint. This technique allowed us to fix the small bone fragment rigidly and mobilize the interphalangeal joint earlier to preserve the range of motion. It would be a valuable procedure when the bone fragment is small.

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Injuries to the great toe

York

Wydra

Hunt

2017

Curr Rev Musculoskelet Med

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Toe injuries have been found to represent nearly 10% of injuries presenting to fracture clinics. While most injuries can be treated nonsurgically, there are a number of specific injuries that require a high index of suspicion, careful management, and in some cases, surgical intervention. Injuries detailed in this review include turf toe, traumatic bunion, and hallux and sesamoid fractures. Additional pathologies that are covered include sesamoiditis and sesamoid avascular necrosis as well as hallux rigidus. Appropriate workup and current treatment recommendations are discussed. Injuries to the hallux can result in long-term pain and disability if not properly diagnosed and treated. A high index of suspicion is required.

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Temporary Kirschner wire fixation for a mallet toe of the hallux

Cited by 18 publications

References 8 publications

Self-made adjustable external fixation device with progressive compression for the management of open fracture with bone defects of the distal hallux phalanx: a case report

Self-made adjustable external fixation device with progressive compression for the management of open fracture with bone defects of the distal hallux phalanx: a case report

Mallet Toe of the Hallux Treated by Bridging Suture Technique Using Suture Anchors: A Case Report and Literature Review

Injuries to the great toe

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