Two Extension Block Kirschner Wires' Technique for Bony Mallet Thumb.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Mallet finger injuries are common, but mallet thumb injuries are exceptionally rare.
• These injuries often involve avulsion fractures of the distal phalanx or extensor tendon ruptures.

Purpose of the Study:

• To present a case of mallet thumb with a large avulsion fracture.
• To describe the successful management of this rare injury using a specific surgical technique.

Main Methods:

• A 19-year-old female patient with a mallet thumb injury sustained during basketball.
• Diagnosis confirmed via plain radiographs and computed tomography, revealing a large avulsion fracture.
• Treatment involved closed reduction and percutaneous fixation with the two extension block Kirschner wires technique under digital block anesthesia.

Main Results:

• Excellent functional recovery was achieved at 4 months postoperatively, as per Crawford's criteria.
• The patient experienced no difficulties with daily work or athletic activities, including basketball.
• The chosen technique minimized invasion of the extensor mechanism and nail bed.

Conclusions:

• The two extension block Kirschner wires technique is a viable and effective option for managing mallet thumb with large avulsion fractures.
• This minimally invasive approach allows for stable fixation and excellent functional outcomes.
• Early and appropriate surgical intervention can restore full function in patients with mallet thumb injuries.