Lee Seung Hoo, Lee Jung Eun, Lee Ki Ho, Pyo Sung Hee, Kim Min Bom, Lee Young Ho
Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea.
Department of Orthopaedic Surgery, Gachon University Gil Medical Center, Seongnam, Korea.
J Hand Surg Am. 2019 Aug;44(8):695.e1-695.e8. doi: 10.1016/j.jhsa.2018.09.016. Epub 2018 Nov 6.
We suggest a method to achieve anatomical reduction in mallet finger fractures that are insufficiently treated by the 2-extension block wire technique.
We performed a retrospective review of 18 patients who were found to have an irreducible dorsal fragment and distal interphalangeal joint incongruence owing to rotation of the dorsal fragment in the sagittal plane. In these cases, we additionally employed a dorsal counterforce technique to supplement the 2-extension block technique. An additional K-wire was used to apply counterforce against the distal part of the dorsal fragment and control rotation in the sagittal plane.
All 18 fractures united. Congruent joint surfaces and anatomical reduction were seen in all cases. The mean active flexion of the distal interphalangeal joints was 83.8° (range, 79°-88°) and the mean extension loss was 0.4° (range, 0°-4°).
We believe that the dorsal counterforce technique effectively supplements the 2-extension block K-wire technique and aids control of dorsal fragment rotation in the sagittal plane.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
