Tips Under the Skin: A Simple Modification of Extension Block Pinning for Mallet Fractures

Pins exposed out of the skin after surgery for mallet fractures keep patients from washing their hands. The authors buried the tips of all pins under the skin while performing extension block pinning for 14 patients with mallet fractures. The patients were allowed to wash their hands 4 to 5 days postoperatively, without any dressing or splinting. The pins were removed at a mean of 8 weeks postoperatively. Solid union was achieved in all 14 fractures. No pull-out or subsidence of the pin was observed. No patient developed infection or other pin-related complications. Mean extension lag at final follow-up was 4°. [Orthopedics. 2018; 41(2):e299-e302.].