J Korean Fract Soc.  2009 Oct;22(4):283-287. 10.12671/jkfs.2009.22.4.283.

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

• Han CS
• Chung DW
• Jeong BO
• Park HC
• Kim JY
• Park CH
• Park JS

• KMID: 1469996
• DOI: http://doi.org/10.12671/jkfs.2009.22.4.283

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 3.7degrees (0~10degrees) in extension lag and 76.7degrees (60~90degrees) 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.

Keyword

Mallet fracture; Distal phalanx; Towel clip; K-wire

MeSH Terms

Fingers
Follow-Up Studies
Humans
Joints
Range of Motion, Articular

Figure

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

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  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.

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  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.

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

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

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

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