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Related Experiment Video

Updated: Feb 7, 2026

Transverse Fracture of the Mouse Femur with Stabilizing Pin
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Extension block and direct pinning methods for mallet fracture: A comparative study.

Hyun Ho Han1, Hyun Jun Cho2, Seong Yeon Kim2

  • 1Department of Plastic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.

Archives of Plastic Surgery
|July 25, 2018
PubMed
Summary

The direct pinning method (DPM) for mallet fractures showed better outcomes than the extension block method (EBM), with greater improvements in finger extensor lag and range of motion. Both surgical techniques yielded good results for mallet fracture treatment.

Keywords:
Closed fracture reductionFingersFractureTendon injuries

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Area of Science:

  • Orthopedic surgery
  • Hand surgery
  • Traumatology

Background:

  • Mallet fractures commonly occur in sports and daily life, with treatment methods still debated.
  • Surgical interventions for mallet fractures include various closed reduction techniques.
  • Comparing the extension block method (EBM) and direct pinning method (DPM) is crucial for optimizing treatment.

Purpose of the Study:

  • To compare the efficacy of the extension block method (EBM) and direct pinning method (DPM) for treating mallet fractures.
  • To assess differences in range of motion and finger movement measurements post-surgery.
  • To evaluate clinical outcomes using Crawford's criteria.

Main Methods:

  • Retrospective evaluation of 41 patients undergoing surgery between August 2013 and September 2015.
  • 21 patients treated with EBM, 20 patients treated with DPM.
  • Comparison of extensor lag, range of motion, and Crawford's criteria outcomes pre- and post-operatively (6-8 months).

Main Results:

  • DPM group showed greater improvement in postoperative extensor lag (10.73°) compared to EBM (4.28°).
  • DPM group achieved a larger postoperative arc of motion (61.17°) versus EBM (55.76°).
  • Crawford assessment scores were higher in the DPM group (3.5) than the EBM group (3.1), though not statistically significant.

Conclusions:

  • Both EBM and DPM are effective closed reduction methods for mallet fracture treatment.
  • DPM demonstrated superiority over EBM, yielding superior improvements in extensor lag and range of motion.
  • DPM may be a preferred surgical option for mallet fractures due to enhanced functional recovery.