September 30, 2014
10:19:30am
WSPC/135-HS
FA1
1450034
Hand Surgery, Vol. 19, No. 3 (2014) 399–403 © World Scientific Publishing Company DOI: 10.1142/S0218810414500348
TREATMENT OF CHRONIC MALLET FRACTURES USING EXTENSION-BLOCK KIRSCHNER WIRE Kenichi Asano,* Goro Inoue† and Masaki Shin‡
Hand Surg. 2014.19:399-403. Downloaded from www.worldscientific.com by CHINESE UNIVERSITY OF HONG KONG on 02/09/15. For personal use only.
*Department
of Orthopaedic Surgery Hamamatsu Medical Center Shizuoka 432-8580, Japan
†Department
of Orthopaedic Surgery Seiyukai Ezaki Hospital Aichi 440-0883, Japan
‡
Department of Orthopaedic Surgery Toyohashi Municipal Hospital Aichi 441-8570, Japan
Received 16 March 2014; Revised 27 May 2014; Accepted 27 May 2014; Published 1 October 2014 ABSTRACT Eleven patients with chronic mallet fractures that were seen later than four weeks after injury were treated by extension-block Kirschner wire technique. The average duration from injury to operative treatment was 56 days (range, 28–111). The follow-up evaluations took place after a mean of eight months. The radiographic bone union was obtained in all patients. The average extension loss of the DIP joint was 4 degree (range, 0–15) and the average flexion was 68 degree (range, 43–90). The results according to Crawford’s criteria were six excellent, two good, two fair, and one poor. We would say that the technique we treated is effective method of treatment for younger patients with chronic mallet fractures. Keywords: Chronic; Mallet Fracture; Extension-Block Kirschner Wire.
INTRODUCTION
advocated the necessity of obtaining an accurate reduction in chronic mallet fractures in order to prevent joint deformity, secondary arthritis and stiffness. Open reduction is sometimes hazardous for damage of avulsed fragments because of the small size of the fragments and the difficulty in visualizing the articular congruity. In order to avoid these risks, we used the extension-block K-wire technique for the treatment of chronic mallet fractures that are seen later than four weeks after injury.
Extension-block Kirschner (K) wire technique for acute mallet fractures was described by several authers.1–5 This technique is simple, and is easier than other techniques for reduction of mallet fractures and it provides satisfactory results. There are few reports concerning the treatment of these chronic injuries. Patel6 presented chronic mallet fractures that have done well after only closed splint treatment for eight weeks. However, other authors7,8
Correspondence to: Dr. Kenichi Asano, Department of Orthopaedic Surgery, Hamamatsu Medical Center, 328 Tomitsuka-cho, Naka-ku, Hamamatsu, Shizuoka 4328580, Japan. Tel: (þ53) 453-7111, Fax: (þ53) 452-9217, E-mail: [email protected] 399
September 30, 2014
400
10:19:32am
WSPC/135-HS
FA1
1450034
K. Asano, G. Inoue & M. Shin
Hand Surg. 2014.19:399-403. Downloaded from www.worldscientific.com by CHINESE UNIVERSITY OF HONG KONG on 02/09/15. For personal use only.
PROCEDURE
and (3) insufficient patient cooperation with a splinting regimen. Exclusion criteria included (1) a fracture involving less than one-third of the articular surface; (2) a fracture with osteoarthrosis; and (3) patient age over thirty years. There were four men and seven women with an average age of 16 (range, 11–26). The index was involved in five cases, the middle finger in one, the ring finger in three, and the little finger in two. The average duration from injury to operative treatment was 56 days (range, 28–111). The size of the fracture fragment was one-third to half of the joint surface in four cases and half or more of the joint surface in seven. Subluxation of the distal phalanx was observed in seven cases. According to the Wehbe and Schneider classification,9 there were four type I b and 7 type II b fractures. The average follow-up period was eight months (range, 4–17). All cases were subjected to clinical and radiological examination. Five cases had only medical record and six cases had both medical record and radiograph. In those cases which had radiograph, we examined the amount of fragment displacement, articular gap and step-off (post-op and final follow-up). Results were assessed on pain, range of motion (ROM) of the DIP joint and radiographs. The criteria of Crawford10 was used to assess the results (Table 1).
Under digital block anesthesia, the distal phalanx is flexed and maintained in its position. A 0.035- or 0.045-inch K-wire is introduced into the head of the middle phalanx along the dorsal edge of the fragment under image intensifier control. Closed reduction is obtained by extending the distal interphalangeal (DIP) joint, and applying distal traction of the finger and dorsally directed pressure on the base of the distal phalanx. Percutaneous needle curettage of the fibrous tissue between the fragment and distal phalanx is not performed. A second transfixion longitudinal K-wire is then driven across the joint into the middle phalanx. A radiograph must be obtained to verify congruity of the articular surface and reduction of the subluxation of the distal phalanx. No further immobilisation is necessary and active motion of the proximal interphalangeal joint and metacarpophalangeal joint are encouraged immediately after operation. The extension-block K-wire is to be removed after four weeks. The transfixion longitudinal K-wire is left in place for five to six weeks until union is demonstrated by radiograph.
PATIENTS AND METHODS Eleven patients with chronic mallet fractures were treated by using extension-block K-wire technique. Chronic injuries were defined as mallet fractures that remained in an unreduced position for a minimum of four weeks after injury. Our surgical indications were (1) a fracture involving more than one-third of the articular surface; (2) a subluxated distal phalanx; Table 1
Case 1 2 3 4 5 6 7 8 9 10 11
RESULTS Ten patients had no pain, while one had slight pain. The average extension loss of the DIP joint was 4 degrees (range, 0– 15) and the average flexion was 68 degrees (range, 43–90). The radiographic bone union was obtained in all patients. There
Patients and Results.
Sex
Age (Years)
Time from Injury to Operation (Days)
Follow-Up (Months)
E/F
Crawford Score
M F F F M M F F M F F
22 18 16 14 19 26 14 12 11 15 16
37 78 83 30 30 35 111 42 28 85 28
7 7 14 4 6 8 8 7 17 5 7
0/90 15/50 0/65 0/70 0/60 8/43 0/80 5/80 0/80 0/67 15/65
E F E E G P E G E E F
Displacement (mm)
Gap Post-Op (mm)
Gap f/u (mm)
Step-Off Post-Op (mm)
2
0.5
0
1
0.5
2 4 2 3 4
1 2 0.5 1 1
0 1 0 0 0
0 1 0.5 0 1
0 0.5 0 0 0.5
Step-Off f/u (mm)
September 30, 2014
10:19:32am
WSPC/135-HS
1450034
FA1
Treatment of Chronic Mallet Fractures Using Extension-Block Kirschner Wire
Hand Surg. 2014.19:399-403. Downloaded from www.worldscientific.com by CHINESE UNIVERSITY OF HONG KONG on 02/09/15. For personal use only.
were no cases of psudoarthrosis. The average fragment displacement was 2.8 mm (range, 2–4). The average articular gap of post-op was 1 mm (range, 0.5–2) and final follow-up was 0.17 mm (range, 0–1). The average articular step-off of post-op was 0.58 mm (range, 0–1) and final follow-up was 0.25 mm (range, 0–0.5). The final outcomes were excellent in six cases, good in two, fair in two and poor in one. One patient treated 35 days after injury was classified as having poor result because of 20 degrees of flexion loss with slight pain, although he had good extension. No pin tract infections were encountered.
DISCUSSION The conservative treatment of chronic mallet fractures had been reported by several authors.6,10–12 They had good results when the fracture fragment was less than one-third of the articular surface. However, we were unable to anatomically reduce the fracture gap and palmar subluxation of the distal phalanx because of fibrous tissues interposition between the fracture fragment and the distal phalanx. Ishiguro2 recommended extension-block K-wire technique with percutaneous needle curettage of fibrous tissues between the fracture fragments when 3–5 weeks have passed, and open reduction when more than five weeks have passed. However, open reduction carries some risks for damage of avulsed fragment; Stern13 and
401
Kang14 reported higher rates of complications in patients treated operatively than in patients treated conservatively. It is unclear that fibrous tissues between the fracture fragments are able to be removed by using percutaneous needle technique. Thus, we used extension-block K-wire technique to minimize the risk of complications even for the treatment of chronic mallet fractures. The displacement remained more in chronic mallet fractures than in acute fractures because of fibrous tissues between the fragment and the distal phalanx. Closed reduction using extension-block K-wire technique was a risk of residual displacement. However, 1 mm gap of the articular surface was gradually remodeled (Fig. 1). Step-off of the articular surface was remodelled when the displacement was 0.5 mm (Fig. 2). It is possible for a gap of 1 mm and a step-off of 0.5 mm to remodel the articular surface. It is important that palmar subluxation of the distal phalanx must be reduced anatomically because residual subluxation leads to secondary osteoarthrosis. In our study, radiographic bone union was obtained in all patients. The average extension loss of the DIP joint was 4 degrees and the average flexion was 68 degrees. We observed residual extension lag in four cases, but other complications were not observed. Lee8 reported 23 cases of pull-out wire suture technique for the treatment of chronic mallet fractures. In his report, the average extension loss of the DIP joint was 4
(A)
(B)
(C)
(D)
Fig. 1 Lateral radiographs of a 15-year-old girl. (A) Pre-operative radiograph, 85 days after injury. (B) Post-operative radiograph. (C) Six weeks after operation, Kirschner wires were removed. (D) Five months after operation, the patient had a full range of motion without pain.
September 30, 2014
Hand Surg. 2014.19:399-403. Downloaded from www.worldscientific.com by CHINESE UNIVERSITY OF HONG KONG on 02/09/15. For personal use only.
402
10:19:34am
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FA1
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K. Asano, G. Inoue & M. Shin
(A)
(B)
(C)
(D)
Fig. 2 Lateral radiographs of a 11-year-old boy. (A) Pre-operative radiograph, four weeks after injury, shows palmar subluxation of the distal phalanx. (B) Post-operative radiograph. (C) Five weeks after operation, Kirschner wires were removed. (D) Radiograph at 17 months after operation shows the remodeling of the articular surface.
degrees and the average flexion was 72 degrees. Six patients had residual extension lag, one had superficial wound infection and five had mild paresthesia. Our clinical results of ROM of the DIP joint were equivalent to Lee’s. On the other hand, extension-block K-wire technique had less complications than pull-out wire suture technique. The average age in our cases was 16. The lower age could have given some advantage with regard to fracture healing. Even so, mallet finger injuries are usually observed during sports activities such as rugby, volleyball and basketball.15 The majority of these injuries occurs in young people, especially in 10 to 20 years old. In our cases, nine patients were under 20 years of age. The oldest patient was 26 years old, and he had pain and persisted flexion loss. But other cases under 22 years of age were obtained satisfactory results. When we try to analyse other factors that affect outcome, insufficient reduction may be associated with poor outcome. The cases which were not gap and step-off at final follow-up were all obtained excellent results. We believe this simple technique for closed reduction of chronic mallet fractures using an extension-block K-wire is of benefit to younger patients less than four months standing.
References 1. Inoue G, Closed reduction of mallet fractures using extension-block Kirschner wire, J Orthop Trauma 6(4):413–415, 1992. 2. Ishiguro T, Yabe Y, Itoh Y, Hashizume N, Extension block with Kirschner wire for fracture dislocation of the distal interphalangeal joint, Tech Hand Upper Extremity Surg 1:95–102, 1997. 3. Darder-Prats A, Fernandez-Garcia E, Fernandez-Gabarda R, DarderGarcia A, Treatment of mallet finger fractures by the extension-block K-wire technique, J Hand Surg Br 23(6):802–805, 1998. 4. Pegoli L, Toh S, Arai K, Fukuda A, Nishikawa S, Vallejo IG, The Ishiguro extension block technique for the treatment of mallet finger fracture: Indications and clinical results, J Hand Surg Br 28(1):15–17, 2003. 5. Hofmeister EP, Mazurek MT, Shin AY, Bishop AT, Extension block pinning for large mallet fractures, J Hand Surg Am 28(3):453–459, 2003. 6. Patel MR, Desai SS, Bassini-Lipson L, Conservative management of chronic mallet finger, J Hand Surg Am 11(4):570–573, 1986. 7. Ulusoy MG, Karalezli N, Kocer U, Uysal A, Karaaslan O, Kankaya Y, Aslan C, Pull-in suture technique for the treatment of mallet finger, Plast Reconstr Surg 118(3):696–702, 2006. 8. Lee SK, Kim HJ, Lee KW, Kim KJ, Choy WS, Modified pull-out wire suture technique for the treatment of chronic bony mallet finger, Ann Plast Surg 65(5):466–470, 2010. 9. Wehbe MA, Schneider LH, Mallet fractures, J Bone Joint Surg Am 66(5):658–669, 1984.
September 30, 2014
10:19:37am
WSPC/135-HS
1450034
FA1
Treatment of Chronic Mallet Fractures Using Extension-Block Kirschner Wire
Hand Surg. 2014.19:399-403. Downloaded from www.worldscientific.com by CHINESE UNIVERSITY OF HONG KONG on 02/09/15. For personal use only.
10. Crawford GP, The molded polythene splint for mallet finger deformities, J Hand Surg Am 9(2):231–237, 1984. 11. McFarlane RM, Hampole MK, Treatment of extensor injuries of the hand, Can J Surg 16(6):366–375, 1973. 12. Garberman SF, Diao E, Peimer CA, Mallet finger: Results of early versus delayed closed treatment, J Hand Surg Am 19(5):850–852, 1994.
403
13. Stern PJ, Kastrup JJ, Complications and prognosis of treatment of mallet finger, J Hand Surg Am 13(3):329–334, 1988. 14. Kang HJ, Shin SJ, Kang ES, Complications of operative treatment for mallet fractures of the distal phalanx, J Hand Surg Br 26(1):28–31, 2001. 15. Simpson D, McQueen MM, Kumar P, Mallet deformity in sport, J Hand Surg Br 26(1):32–33, 2001.
10:19:30am
WSPC/135-HS
FA1
1450034
Hand Surgery, Vol. 19, No. 3 (2014) 399–403 © World Scientific Publishing Company DOI: 10.1142/S0218810414500348
TREATMENT OF CHRONIC MALLET FRACTURES USING EXTENSION-BLOCK KIRSCHNER WIRE Kenichi Asano,* Goro Inoue† and Masaki Shin‡
Hand Surg. 2014.19:399-403. Downloaded from www.worldscientific.com by CHINESE UNIVERSITY OF HONG KONG on 02/09/15. For personal use only.
*Department
of Orthopaedic Surgery Hamamatsu Medical Center Shizuoka 432-8580, Japan
†Department
of Orthopaedic Surgery Seiyukai Ezaki Hospital Aichi 440-0883, Japan
‡
Department of Orthopaedic Surgery Toyohashi Municipal Hospital Aichi 441-8570, Japan
Received 16 March 2014; Revised 27 May 2014; Accepted 27 May 2014; Published 1 October 2014 ABSTRACT Eleven patients with chronic mallet fractures that were seen later than four weeks after injury were treated by extension-block Kirschner wire technique. The average duration from injury to operative treatment was 56 days (range, 28–111). The follow-up evaluations took place after a mean of eight months. The radiographic bone union was obtained in all patients. The average extension loss of the DIP joint was 4 degree (range, 0–15) and the average flexion was 68 degree (range, 43–90). The results according to Crawford’s criteria were six excellent, two good, two fair, and one poor. We would say that the technique we treated is effective method of treatment for younger patients with chronic mallet fractures. Keywords: Chronic; Mallet Fracture; Extension-Block Kirschner Wire.
INTRODUCTION
advocated the necessity of obtaining an accurate reduction in chronic mallet fractures in order to prevent joint deformity, secondary arthritis and stiffness. Open reduction is sometimes hazardous for damage of avulsed fragments because of the small size of the fragments and the difficulty in visualizing the articular congruity. In order to avoid these risks, we used the extension-block K-wire technique for the treatment of chronic mallet fractures that are seen later than four weeks after injury.
Extension-block Kirschner (K) wire technique for acute mallet fractures was described by several authers.1–5 This technique is simple, and is easier than other techniques for reduction of mallet fractures and it provides satisfactory results. There are few reports concerning the treatment of these chronic injuries. Patel6 presented chronic mallet fractures that have done well after only closed splint treatment for eight weeks. However, other authors7,8
Correspondence to: Dr. Kenichi Asano, Department of Orthopaedic Surgery, Hamamatsu Medical Center, 328 Tomitsuka-cho, Naka-ku, Hamamatsu, Shizuoka 4328580, Japan. Tel: (þ53) 453-7111, Fax: (þ53) 452-9217, E-mail: [email protected] 399
September 30, 2014
400
10:19:32am
WSPC/135-HS
FA1
1450034
K. Asano, G. Inoue & M. Shin
Hand Surg. 2014.19:399-403. Downloaded from www.worldscientific.com by CHINESE UNIVERSITY OF HONG KONG on 02/09/15. For personal use only.
PROCEDURE
and (3) insufficient patient cooperation with a splinting regimen. Exclusion criteria included (1) a fracture involving less than one-third of the articular surface; (2) a fracture with osteoarthrosis; and (3) patient age over thirty years. There were four men and seven women with an average age of 16 (range, 11–26). The index was involved in five cases, the middle finger in one, the ring finger in three, and the little finger in two. The average duration from injury to operative treatment was 56 days (range, 28–111). The size of the fracture fragment was one-third to half of the joint surface in four cases and half or more of the joint surface in seven. Subluxation of the distal phalanx was observed in seven cases. According to the Wehbe and Schneider classification,9 there were four type I b and 7 type II b fractures. The average follow-up period was eight months (range, 4–17). All cases were subjected to clinical and radiological examination. Five cases had only medical record and six cases had both medical record and radiograph. In those cases which had radiograph, we examined the amount of fragment displacement, articular gap and step-off (post-op and final follow-up). Results were assessed on pain, range of motion (ROM) of the DIP joint and radiographs. The criteria of Crawford10 was used to assess the results (Table 1).
Under digital block anesthesia, the distal phalanx is flexed and maintained in its position. A 0.035- or 0.045-inch K-wire is introduced into the head of the middle phalanx along the dorsal edge of the fragment under image intensifier control. Closed reduction is obtained by extending the distal interphalangeal (DIP) joint, and applying distal traction of the finger and dorsally directed pressure on the base of the distal phalanx. Percutaneous needle curettage of the fibrous tissue between the fragment and distal phalanx is not performed. A second transfixion longitudinal K-wire is then driven across the joint into the middle phalanx. A radiograph must be obtained to verify congruity of the articular surface and reduction of the subluxation of the distal phalanx. No further immobilisation is necessary and active motion of the proximal interphalangeal joint and metacarpophalangeal joint are encouraged immediately after operation. The extension-block K-wire is to be removed after four weeks. The transfixion longitudinal K-wire is left in place for five to six weeks until union is demonstrated by radiograph.
PATIENTS AND METHODS Eleven patients with chronic mallet fractures were treated by using extension-block K-wire technique. Chronic injuries were defined as mallet fractures that remained in an unreduced position for a minimum of four weeks after injury. Our surgical indications were (1) a fracture involving more than one-third of the articular surface; (2) a subluxated distal phalanx; Table 1
Case 1 2 3 4 5 6 7 8 9 10 11
RESULTS Ten patients had no pain, while one had slight pain. The average extension loss of the DIP joint was 4 degrees (range, 0– 15) and the average flexion was 68 degrees (range, 43–90). The radiographic bone union was obtained in all patients. There
Patients and Results.
Sex
Age (Years)
Time from Injury to Operation (Days)
Follow-Up (Months)
E/F
Crawford Score
M F F F M M F F M F F
22 18 16 14 19 26 14 12 11 15 16
37 78 83 30 30 35 111 42 28 85 28
7 7 14 4 6 8 8 7 17 5 7
0/90 15/50 0/65 0/70 0/60 8/43 0/80 5/80 0/80 0/67 15/65
E F E E G P E G E E F
Displacement (mm)
Gap Post-Op (mm)
Gap f/u (mm)
Step-Off Post-Op (mm)
2
0.5
0
1
0.5
2 4 2 3 4
1 2 0.5 1 1
0 1 0 0 0
0 1 0.5 0 1
0 0.5 0 0 0.5
Step-Off f/u (mm)
September 30, 2014
10:19:32am
WSPC/135-HS
1450034
FA1
Treatment of Chronic Mallet Fractures Using Extension-Block Kirschner Wire
Hand Surg. 2014.19:399-403. Downloaded from www.worldscientific.com by CHINESE UNIVERSITY OF HONG KONG on 02/09/15. For personal use only.
were no cases of psudoarthrosis. The average fragment displacement was 2.8 mm (range, 2–4). The average articular gap of post-op was 1 mm (range, 0.5–2) and final follow-up was 0.17 mm (range, 0–1). The average articular step-off of post-op was 0.58 mm (range, 0–1) and final follow-up was 0.25 mm (range, 0–0.5). The final outcomes were excellent in six cases, good in two, fair in two and poor in one. One patient treated 35 days after injury was classified as having poor result because of 20 degrees of flexion loss with slight pain, although he had good extension. No pin tract infections were encountered.
DISCUSSION The conservative treatment of chronic mallet fractures had been reported by several authors.6,10–12 They had good results when the fracture fragment was less than one-third of the articular surface. However, we were unable to anatomically reduce the fracture gap and palmar subluxation of the distal phalanx because of fibrous tissues interposition between the fracture fragment and the distal phalanx. Ishiguro2 recommended extension-block K-wire technique with percutaneous needle curettage of fibrous tissues between the fracture fragments when 3–5 weeks have passed, and open reduction when more than five weeks have passed. However, open reduction carries some risks for damage of avulsed fragment; Stern13 and
401
Kang14 reported higher rates of complications in patients treated operatively than in patients treated conservatively. It is unclear that fibrous tissues between the fracture fragments are able to be removed by using percutaneous needle technique. Thus, we used extension-block K-wire technique to minimize the risk of complications even for the treatment of chronic mallet fractures. The displacement remained more in chronic mallet fractures than in acute fractures because of fibrous tissues between the fragment and the distal phalanx. Closed reduction using extension-block K-wire technique was a risk of residual displacement. However, 1 mm gap of the articular surface was gradually remodeled (Fig. 1). Step-off of the articular surface was remodelled when the displacement was 0.5 mm (Fig. 2). It is possible for a gap of 1 mm and a step-off of 0.5 mm to remodel the articular surface. It is important that palmar subluxation of the distal phalanx must be reduced anatomically because residual subluxation leads to secondary osteoarthrosis. In our study, radiographic bone union was obtained in all patients. The average extension loss of the DIP joint was 4 degrees and the average flexion was 68 degrees. We observed residual extension lag in four cases, but other complications were not observed. Lee8 reported 23 cases of pull-out wire suture technique for the treatment of chronic mallet fractures. In his report, the average extension loss of the DIP joint was 4
(A)
(B)
(C)
(D)
Fig. 1 Lateral radiographs of a 15-year-old girl. (A) Pre-operative radiograph, 85 days after injury. (B) Post-operative radiograph. (C) Six weeks after operation, Kirschner wires were removed. (D) Five months after operation, the patient had a full range of motion without pain.
September 30, 2014
Hand Surg. 2014.19:399-403. Downloaded from www.worldscientific.com by CHINESE UNIVERSITY OF HONG KONG on 02/09/15. For personal use only.
402
10:19:34am
WSPC/135-HS
FA1
1450034
K. Asano, G. Inoue & M. Shin
(A)
(B)
(C)
(D)
Fig. 2 Lateral radiographs of a 11-year-old boy. (A) Pre-operative radiograph, four weeks after injury, shows palmar subluxation of the distal phalanx. (B) Post-operative radiograph. (C) Five weeks after operation, Kirschner wires were removed. (D) Radiograph at 17 months after operation shows the remodeling of the articular surface.
degrees and the average flexion was 72 degrees. Six patients had residual extension lag, one had superficial wound infection and five had mild paresthesia. Our clinical results of ROM of the DIP joint were equivalent to Lee’s. On the other hand, extension-block K-wire technique had less complications than pull-out wire suture technique. The average age in our cases was 16. The lower age could have given some advantage with regard to fracture healing. Even so, mallet finger injuries are usually observed during sports activities such as rugby, volleyball and basketball.15 The majority of these injuries occurs in young people, especially in 10 to 20 years old. In our cases, nine patients were under 20 years of age. The oldest patient was 26 years old, and he had pain and persisted flexion loss. But other cases under 22 years of age were obtained satisfactory results. When we try to analyse other factors that affect outcome, insufficient reduction may be associated with poor outcome. The cases which were not gap and step-off at final follow-up were all obtained excellent results. We believe this simple technique for closed reduction of chronic mallet fractures using an extension-block K-wire is of benefit to younger patients less than four months standing.
References 1. Inoue G, Closed reduction of mallet fractures using extension-block Kirschner wire, J Orthop Trauma 6(4):413–415, 1992. 2. Ishiguro T, Yabe Y, Itoh Y, Hashizume N, Extension block with Kirschner wire for fracture dislocation of the distal interphalangeal joint, Tech Hand Upper Extremity Surg 1:95–102, 1997. 3. Darder-Prats A, Fernandez-Garcia E, Fernandez-Gabarda R, DarderGarcia A, Treatment of mallet finger fractures by the extension-block K-wire technique, J Hand Surg Br 23(6):802–805, 1998. 4. Pegoli L, Toh S, Arai K, Fukuda A, Nishikawa S, Vallejo IG, The Ishiguro extension block technique for the treatment of mallet finger fracture: Indications and clinical results, J Hand Surg Br 28(1):15–17, 2003. 5. Hofmeister EP, Mazurek MT, Shin AY, Bishop AT, Extension block pinning for large mallet fractures, J Hand Surg Am 28(3):453–459, 2003. 6. Patel MR, Desai SS, Bassini-Lipson L, Conservative management of chronic mallet finger, J Hand Surg Am 11(4):570–573, 1986. 7. Ulusoy MG, Karalezli N, Kocer U, Uysal A, Karaaslan O, Kankaya Y, Aslan C, Pull-in suture technique for the treatment of mallet finger, Plast Reconstr Surg 118(3):696–702, 2006. 8. Lee SK, Kim HJ, Lee KW, Kim KJ, Choy WS, Modified pull-out wire suture technique for the treatment of chronic bony mallet finger, Ann Plast Surg 65(5):466–470, 2010. 9. Wehbe MA, Schneider LH, Mallet fractures, J Bone Joint Surg Am 66(5):658–669, 1984.
September 30, 2014
10:19:37am
WSPC/135-HS
1450034
FA1
Treatment of Chronic Mallet Fractures Using Extension-Block Kirschner Wire
Hand Surg. 2014.19:399-403. Downloaded from www.worldscientific.com by CHINESE UNIVERSITY OF HONG KONG on 02/09/15. For personal use only.
10. Crawford GP, The molded polythene splint for mallet finger deformities, J Hand Surg Am 9(2):231–237, 1984. 11. McFarlane RM, Hampole MK, Treatment of extensor injuries of the hand, Can J Surg 16(6):366–375, 1973. 12. Garberman SF, Diao E, Peimer CA, Mallet finger: Results of early versus delayed closed treatment, J Hand Surg Am 19(5):850–852, 1994.
403
13. Stern PJ, Kastrup JJ, Complications and prognosis of treatment of mallet finger, J Hand Surg Am 13(3):329–334, 1988. 14. Kang HJ, Shin SJ, Kang ES, Complications of operative treatment for mallet fractures of the distal phalanx, J Hand Surg Br 26(1):28–31, 2001. 15. Simpson D, McQueen MM, Kumar P, Mallet deformity in sport, J Hand Surg Br 26(1):32–33, 2001.
