Extension-block pinning for treatment of displaced mallet fractures

Mallet injuries are common in active individuals, particularly those who participate in sports such as basketball and football. Although a majority of patients with displaced mallet fractures are treated conservatively with extension splinting, their treatment is often complicated by residual loss of extension and fracture displacement secondary to unfavorable fracture biomechanics and poor patient compliance. An attractive alternative to nonoperative treatment is the minimally invasive technique of extension-block percutaneous pinning. Extension-block percutaneous pinning allows anatomic restoration of the articular surfaces and avoids the complications associated with closed treatment. The technique is easy to perform and is an effective, safe alternative to the conservative treatment of displaced mallet fractures, particularly those associated with joint subluxation.