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Extension Block Kirschner Wire Fixation for Acute Bony Mallet Finger: A Retrospective Analysis
Sevan Sıvacıoğlu1, Fatih Şentürk2, Muhammet Buğra Tellioğlu2
1Private Practice, Department Of Orthopedics And Traumatology, Istanbul, Turkey.
Summary
Early surgical fixation of bony mallet finger using extension-block Kirschner wire technique yields high union rates and excellent functional outcomes. This minimally invasive approach demonstrates safety and effectiveness for acute distal phalanx fractures.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Traumatology
Background:
- Bony mallet finger, a distal phalanx fracture, often requires surgical fixation for joint congruity.
- Extension-block Kirschner wire fixation is a minimally invasive technique with reported high success rates.
Purpose of the Study:
- To evaluate clinical and radiological outcomes of acute bony mallet finger treated with extension-block Kirschner wire fixation.
Main Methods:
- Retrospective review of 76 patients with acute bony mallet finger treated surgically.
- Analysis of radiographic union, extension lag, Crawford classification, and complications.
- Fracture classification using Wehbé and Schneider criteria; statistical analysis with Shapiro-Wilk, Wilcoxon signed-rank, and Chi-square/Fisher's exact tests.
Main Results:
- 97% radiographic union achieved; significant improvement in distal interphalangeal (DIP) joint extension lag (8.8° to 2.1°, p < 0.001).
- 80.2% excellent and 13.2% good results per Crawford classification.
- Low complication rate (3.9%) including two non-unions and one malunion.
Conclusions:
- Extension-block Kirschner wire fixation is a safe and effective treatment for acute bony mallet finger.
- Early intervention with this technique leads to excellent functional and radiographic outcomes.
- The procedure is minimally invasive with high union success and low complication rates.
