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Bony Mallet Finger Malunion: Corrective Osteotomy Technique.

Matthew V Abola¹, Troy B Amen, Edward A Athanasian

¹Department of Hand and Upper Extremity, Hospital for Special Surgery, New York, NY.

Techniques in Hand & Upper Extremity Surgery

|August 18, 2025

Summary

This study introduces a new surgical technique using distal phalanx osteotomy to treat chronic mallet finger injuries. This method effectively restores digital extension and function, even in severe cases.

Keywords:

bony mallet finger distal phalanx osteotomy finger malunion

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Area of Science:

Orthopedic Surgery
Hand Surgery
Traumatology

Background:

Chronic mallet finger injuries, especially those with bony malunions, often lead to significant functional impairment and pain.
Existing surgical treatments for chronic mallet finger injuries may not fully restore distal interphalangeal (DIP) joint extension.

Purpose of the Study:

To describe a novel surgical technique using distal phalanx osteotomy for correcting chronic mallet finger injuries.
To evaluate the efficacy of this technique in restoring DIP joint extension and active range of motion.

Main Methods:

A novel surgical technique involving a distal phalanx osteotomy was performed to correct chronic mallet finger injuries.
Postoperative management included splinting with gradual motion exercises.
Full activity resumption was typically achieved by 2.5 months.

Main Results:

The distal phalanx osteotomy technique successfully restored full DIP joint extension and active range of motion.
Patients experienced improvement in extensor lag.
Outcomes were comparable to successful nonoperative treatments for bony and tendinous mallet injuries.

Conclusions:

Distal phalanx osteotomy is an effective novel technique for managing chronic mallet finger injuries, particularly those with bony malunions or hyperlaxity.
This procedure offers a viable solution for restoring digital function and alleviating pain and stiffness associated with chronic mallet finger injuries.