Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy. Università Cattolica del Sacro Cuore, Roma, Italia..
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Acta Biomed. 2022 Mar 10;92(S3):e2021535. doi: 10.23750/abm.v92iS3.12484.
Bony Mallet Finger or Mallet Fracture is a common injury of the hand, which follows a forced flexion of the extended distal interphalangeal joint, that leads to a bony avulsion of the distal phalanx. Depending on fracture extension and dislocation, those lesions can either be treated conservatively or surgically. Several surgical options have been described in the literature. The aim of this study is to compare retrospectively two percutaneous pinning techniques: the extension block technique according to Ishiguro vs an original single Kirshner wiring (Umbrella technique).
Between January 1998 and December 2019, among all patients treated surgically for a Mallet Fracture with either the Ishiguro' and the Umbrella technique, 98 have been included in this study. All patients have been assessed one year after surgery using the Crawford method.
With both techniques better results have been achieved in younger patients and for those treated early. The umbrella technique seems to have better results in patients with fracture classified as 2b or 2c (Wehbe and Schneider classification), whereas the Ishiguro technique seems more appropriate for patients with a 1b fracture. Complication rate and typology vary depending on the used technique.
The Ishiguro' and the Umbrella technique both lead to good results for the treatment of surgical Mallet Fractures. The choice of the best type of pinning should mainly depend on fracture extension and time elapsed from trauma.
锤状指或锤状骨折是手部常见的损伤，通常是由于远节指间关节伸展时受到强迫弯曲而导致的远节指骨骨撕脱。根据骨折的延伸和脱位情况，这些损伤可以通过保守治疗或手术治疗。文献中已经描述了几种手术选择。本研究的目的是回顾性比较两种经皮克氏针固定技术：根据 Ishiguro 的伸展块技术与原创的单根克氏针（伞状技术）。
1998 年 1 月至 2019 年 12 月期间，所有接受手术治疗的锤状骨折患者中，有 98 例采用 Ishiguro 和伞状技术进行治疗，将这些患者纳入本研究。所有患者均在术后一年采用 Crawford 方法进行评估。
两种技术在年轻患者和早期治疗患者中都取得了更好的结果。对于 Wehbe 和 Schneider 分类为 2b 或 2c 的骨折患者，伞状技术似乎效果更好，而对于 1b 骨折患者，Ishiguro 技术似乎更合适。并发症发生率和类型取决于所使用的技术。
Ishiguro 和伞状技术均能有效治疗手术治疗的锤状骨折。选择最佳的针固定类型主要应取决于骨折的延伸程度和创伤后的时间。
