Direct fixation of fracture fragment with modified double Kirschner wires for the treatment of old bony mallet finger

Yong Zhang; Yingluo Gu; Jupu Zhou; Jiaju Zhao; Bo Jiang

doi:10.2340/jphs.v58.18306

Authors

Yong Zhang Department of Hand and Foot Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China https://orcid.org/0000-0002-2783-9768
Yingluo Gu Department of Hand and Foot Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China https://orcid.org/0009-0007-5777-5121
Jupu Zhou Department of Hand and Foot Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China https://orcid.org/0000-0001-6830-8931
Jiaju Zhao Department of Hand and Foot Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China https://orcid.org/0000-0002-8810-3121
Bo Jiang Department of Hand and Foot Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou, Jiangsu, China https://orcid.org/0000-0001-5702-0473

DOI:

https://doi.org/10.2340/jphs.v58.18306

Keywords:

Bony mallet finger, fracture fixation, Kirschner wires, dorsal brace

Abstract

Background: The management of old bony mallet fingers is complicated. The purpose of this study was to describe direct fixation of fracture fragment with modified double Kirschner wires (K-wires) for treatment of old bony mallet finger, and to evaluate the functional outcomes during long-term follow-up.

Methods: Forty-nine patients with old bony mallet finger were enrolled and underwent surgical treatment from August 2014 to January 2021 in our hospital. Patients were divided into two groups according to whether they had undergone triple K-wires fixation or modified double K-wires with a dorsal brace fixation. The operation time, mean number of intraoperative fluoroscopy, bone union time, functional recovery and incidence of complications were monitored.

Results: Neither QuickDASH nor visual analogue scale measurement found statistically significant difference between the two groups (P > 0.05). However, the patients that underwent fixation with double K-wires and a dorsal brace required a shorter operation time and fewer intraoperative fluoroscopy, and exhibited a significantly greater mean final active range of the distal interphalangeal joint flexion, compared to those treated with triple K-wires (P < 0.01).

Conclusion: Direct fixation of fracture fragment with modified double K-wires was an easy and feasible procedure which could achieve anatomical reduction and stable fixation of the dorsal fracture block of old bony mallet finger with relatively few complications.

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