Anatomical Direct Reduction of Bony Mallet Finger Using Modified-Intrafocal Pinning Technique

Kang,  Sang Woo; Park,  Ji Kang; Jung,  Ho Seung; Cha,  Jung Kwon; Kim,  Kook Jong

doi:2018.23.4.248

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Original Article

Archives of Hand and Microsurgery 2018;23(4):248-253.
Published online December 1, 2018.
DOI: https://doi.org/10.12790/ahm.2018.23.4.248

Anatomical Direct Reduction of Bony Mallet Finger Using Modified-Intrafocal Pinning Technique

Sang-Woo Kang, Ji-Kang Park, Ho-Seung Jung, Jung-Kwon Cha, Kook-Jong Kim

Department of Orthopaedic Surgery, Chungbuk National University Hospital, Cheongju, Korea. carm0916@hanmail.net

Received: 4 October 2018 • Revised: 25 October 2018 • Accepted: 26 October 2018

Abstract

Purpose
The purpose of this study was to evaluate the clinical results of anatomic reduction of bony mallet finger using modified-intrafocal pinning technique.

Methods
From March 2014 to October 2017, 18 patients with bony mallet finger were treated with modified-intrafocal pinning technique. Kirschner-wire was used to directly reduction the bony fragment, and extension block pinning and distal interphalangeal joint fixation were additionally performed to minimize the loss of reduction. Postoperative pain, range of motion, and radiological evaluation were performed. Duration of bone healing, functional recovery and complication rate were evaluated and Crawford's criteria was used to determine functional outcome after surgery.

Results
Bone union was achieved in all cases after a postoperative mean of 6 weeks (5–7 weeks). An average of 2.8° (0°–10°) extension loss occurred in all patients. All patients showed satisfactory joint congruency and reformation of the joint surface, the mean flexion angle of the distal interphalangeal joint at the final follow-up was 72.2° (70°–75°). According to Crawford's classification, 12 patients (66.7%) were excellent and 6 patients (33.3%) were good.

Conclusion
Modified-intrafocal pinning technique is a method of obtaining anatomical bone healing by directly reduction and fixation of the bony fragment. Combined with other conventional percutaneous pinning procedures, it is expected that good results can be obtained if applied to appropriate indications.

Key Words: Bony mallet finger, Direct reduction, Anatomical reduction

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