Treatment of bony Mallet finger using threaded Kirschner wire

Abstract

Objectives: The management of bony mallet fingers is controversial. This article describes the technique and outcome of using threaded Kirschner wire to treat mallet fractures involving more than one-third of the articular surface.

Methods: Forty-seven patients were operated on between April 2004 and February 2012. The average follow-up period was 19.6 (range: 8 to 44) months.

Results: According to the Crawford criteria, the results were excellent in 32 patients (69%), good in 12 patients (26%) and fair in 3 patients (6%). The mean range of motion was from 3º (extensor lag) (range: 0° to 15°) to 71º (range: 60° to 80°) flexion. As complications, five patients developed mild degenerative changes, three had pin tract infections, one had temporary nail ridging, and three had skin sloughing. None had persistent postoperative pain.

Conclusion: Threaded Kirschner wire achieved good reduction during surgery and maintained reduction postoperatively for six weeks in mallet fractures.

Key words: Mallet finger, distal phalanx fracture, threaded Kirschner wire.