Chung Soo Han; Duke Whan Chung; Bi O Jeong; Hyun Chul Park; Jin Young Kim; Cheol Hee Park; Jin Sung Park

doi:10.12671/jkfs.2009.22.4.283

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Percutaneous Kirschner Wire Fixation of Acute Mallet Fractures Percutaneousely Reduced by Towel Clip: Chung Soo Han, M.D., Duke Whan Chung, M.D., Bi O Jeong, M.D., Hyun Chul Park, M.D., Jin Young Kim, M.D., Cheol Hee Park, M.D., Jin Sung Park, M.D.; Journal of the Korean Fracture Society 2009;22(4):283-287.
DOI: https://doi.org/10.12671/jkfs.2009.22.4.283
Published online: October 30, 2009

Department of Orthopedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.

^*Department of Orthopedic Surgery, School of Medicine, Gyeongsang National University, Jinju, Korea.

Address reprint requests to: Duke Whan Chung, M.D. Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-701, Korea. Tel: 82-2-958-8368, Fax: 82-2-964-3865, dukech@khmc.or.kr

• Received: May 7, 2009 • Revised: June 15, 2009 • Accepted: August 8, 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
REFERENCES

Abstract

Purpose
To analyze the treatment of clinical results of the percutaneous Kirschner wire fixation of acute mallet fractures percutaneousely reduced by towel clip.
Materials and Methods
From August 2005 to April 2009, we evaluated nine fingers in eight patients, more than three months follow up. The type of injury was a axial loading in seven cases and direct blow in two. The average follow-up period was 10.1 months (range: 3~41 months). The indication of operative treatment was the presence of large bony fragment or the palmar subluxation of the distal phalnx.
Results
The range of motion was 3.7° (0~10°) in extension lag and 76.7° (60~90°) of flexion of the distal interphalangeal joint.
Conclusion
The percutaneous Kirschner wire fixation of acute mallet fractures percutaneousely reduced by towel clip is one of the easy and simple method to stabilizing of bony mallet fracture.
Key words: Mallet fracture, Distal phalanx, Towel clip, K-wire

REFERENCES

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2. Choi JY, Jung HJ, Lee HJ, Son KM, Kim YH. Treatment of bony mallet finger: closed reduction using extension block K-wire. J Korean Fract Soc, 2004;17:362-367.
3. Damron TA, Engber WD. Surgical treatment of mallet finger fractures by tension band technique. Clin Orthop Relat Res, 1994;300:133-140.
4. Hofmeister EP, Mazurek MT, Shin AY, Bishop AT. Extension block pinning for large mallet fractures. J Hand Surg Am, 2003;28:453-459.
5. Inoue G. Closed reduction of mallet fractures using extension-block kirschner wire. J Orthop Trauma, 1992;6:413-415.
6. Ishiguro T, Imai N, Tomatsu T, Noguchi T, Hashizume N. A new method of closed reduction using the spring action of Kirschner wires for fractures of the tibial plateau--a preliminary report. Nippon Seikeigeka Gakkai Zasshi, 1986;60:227-236.
7. King HJ, Shin SJ, Kang ES. Complications of operative treatment for mallet fractures of the distal phalanx. J Hand Surg Br, 2001;26:28-31.
8. Mazurek MT, Hofmeister EP, Shin AY, Bishop AT. Extension-block pinning for treatment of displaced mallet fractures. Am J Orthop, 2002;31:652-654.
9. Tetik C, Gudemez E. Modification of the extension block Kirschner wire technique for mallet fractures. Clin Orthop Relat Res, 2002;404:284-290.
10. Wehbé MA, Schneider LH. Mallet fractures. J Bone Joint Surg Am, 1984;66:658-669.
11. Yi SR, Hahn SH, Yang BK, et al. The result of the modified extension block technique in bony mallet finger. J Korean Fract Soc, 2006;19:236-240.

Fig. 1

Preoperative lateral radiograph shows a displaced mallet fracture.

Fig. 2

Reduction using a towel clip under fluoroscopic guidance. Full extended DIP joint can reduce and compress the bone fragment by tips of a towel clip. Occasionally, manipulation of the distal phalanx with a towel clip is required to obtain an anatomic reduction.

Fig. 3

Maintaining reduction by a towel clip, a 0.035 inch K-wire is inserted through the bony fragment at a 45 angle into the of distal phalanx from dorsal to palmar cortex.

Fig. 4

After removal of a towel clip, a second K-wire is inserted through the bony fragment to distal phalanx.

Fig. 5

A temporally additional K-wire is inserted for stability.

Fig. 6

6 weeks follow up radiograph after the removal of the K-wires.

Table 1

Demographics and clinical outcome of the patients

^*K-wire: Kirschner wire.

Figure & Data

REFERENCES

Citations

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Comparison of Surgical Outcomes of Percutaneous K-Wire Fixation in Bony Mallet Fingers with Use of Towel Clip versus 18-Gauge Needle
Ho-Seung Jeon, Chan-Sam Moon, Seo-Goo Kang, Kyeong-Seop Song, Uk-Hyun Choi
Journal of the Korean Society for Surgery of the Hand.2013; 18(1): 1. CrossRef

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Percutaneous Kirschner Wire Fixation of Acute Mallet Fractures Percutaneousely Reduced by Towel Clip

J Korean Fract Soc. 2009;22(4):283-287. Published online October 31, 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.4.283

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Percutaneous Kirschner Wire Fixation of Acute Mallet Fractures Percutaneousely Reduced by Towel Clip

Fig. 1 Preoperative lateral radiograph shows a displaced mallet fracture.

Fig. 2 Reduction using a towel clip under fluoroscopic guidance. Full extended DIP joint can reduce and compress the bone fragment by tips of a towel clip. Occasionally, manipulation of the distal phalanx with a towel clip is required to obtain an anatomic reduction.

Fig. 3 Maintaining reduction by a towel clip, a 0.035 inch K-wire is inserted through the bony fragment at a 45 angle into the of distal phalanx from dorsal to palmar cortex.

Fig. 4 After removal of a towel clip, a second K-wire is inserted through the bony fragment to distal phalanx.

Fig. 5 A temporally additional K-wire is inserted for stability.

Fig. 6 6 weeks follow up radiograph after the removal of the K-wires.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Fig. 6

Percutaneous Kirschner Wire Fixation of Acute Mallet Fractures Percutaneousely Reduced by Towel Clip

Table 1

Demographics and clinical outcome of the patients

^*K-wire: Kirschner wire.

Table 1 Demographics and clinical outcome of the patients

^*K-wire: Kirschner wire.