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. 2021 Jan;16(1):61-66.
doi: 10.1177/1558944719840749. Epub 2019 Apr 4.

Delayed Extension Block Pinning in 27 Patients With Mallet Fracture

Thomas J M Kootstra  1 , Jort Keizer  1 , Mark van Heijl  2   3 , Steven Ferree  3 , Marijn Houwert  2 , Detlef van der Velde  1
Affiliations

Delayed Extension Block Pinning in 27 Patients With Mallet Fracture

Thomas J M Kootstra et al. Hand (N Y). 2021 Jan.

Abstract

Background: Untreated bony mallet fingers can cause an array of problems; therefore, adequate treatment is essential. The primary aim of this study was to determine the patient-reported functional outcome of delayed surgical intervention of bony mallet fingers. The secondary aim was to determine the complication rate of delayed surgical intervention. Methods: In this single-center retrospective cohort study, all consecutive patients treated between 2010 and 2016 at our level 2 regional teaching hospital were included. Inclusion criterion was a bony mallet finger injury (excluding the thumb), presenting >21 days after injury, treated with extension block pinning. Indications for surgery were >2 mm fragment displacement or volar subluxation of the distal interphalangeal joint. Six to 82 months postoperatively, patients completed the Patient-Rated Wrist and Hand Evaluation (PRWHE) by phone. Complications were extracted by chart review. Results: Twenty-seven patients were included, and all completed the PRWHE. Median time to surgery was 35 days (interquartile range [IQR] = 29-42; range = 22-61). Reasons for delay in surgical treatment were patient/physician delay in 24 cases and failed conservative treatment in 3 cases. The median PRWHE score was 0 (IQR = 0-5; range = 0-22.5). After retrospective assessment of the outpatient charts, no early symptoms of malunion or nonunion were found. One patient had a loss of Kirschner-wire fixation, which was corrected. Three patients had an infection that required antibiotic treatment. Conclusions: Delayed surgical management of bony mallet fingers demonstrated adequate functional outcome with minimal complications when compared with prior literature.

Keywords: delayed; functional; mallet fracture; outcome; surgery.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Preoperative bony mallet finger with an operation indication.
Figure 2.
Figure 2.
Intraoperative fluoroscopy imaging of the extension block pinning technique.
Figure 3.
Figure 3.
A healed postoperative bony mallet finger.
See this image and copyright information in PMC

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