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Management for Bony Mallet Thumb with a Single Extension Blocking Kirschner Wire.
Sean-Tee J M Lim1, Muhammad Abrar Qadeer1, Martin Kelly1
1Department of Orthopaedic Surgery, University Hospital Limerick, St Nessan's Road, Dooradoyle, Co. Limerick, V94 F858, Ireland.
Journal of Orthopaedic Case Reports
|September 24, 2021
Summary
Mallet thumb injuries, though rare, can be effectively treated with a single Kirschner wire fixation technique. This method offers a potentially safer approach for bony mallet thumb injuries, aiding return to sport.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Hand Surgery
Background:
- Mallet thumb injuries involve disruption of the extensor tendon at the distal interphalangeal (DIP) joint.
- While common in fingers, mallet injuries of the thumb are rare.
- Current treatment strategies lack clinical consensus.
Observation:
- A case of a 27-year-old hurling player with a bony mallet thumb injury is presented.
- The injury involved an avulsion fracture of the distal phalanx base, impacting over one-third of the articular surface.
- The patient experienced loss of active extension at the DIP joint.
Findings:
- Closed reduction and percutaneous fixation were performed using a single extension block Kirschner wire.
- No transfixion wire across the DIP joint was used.
- The patient achieved good functional dexterity and returned to playing hurling within four months.
Implications:
- A single K-wire technique may reduce risks of iatrogenic nail bed injury, bone fragment rotation, and chondral damage.
- This technique's application to bony mallet thumb has not been previously reported.
- This approach may offer a beneficial alternative for managing bony mallet thumb injuries.
