J Korean Soc Surg Hand.  2013 Mar;18(1):1-8. 10.12790/jkssh.2013.18.1.1.

Comparison of Surgical Outcomes of Percutaneous K-Wire Fixation in Bony Mallet Fingers with Use of Towel Clip versus 18-Gauge Needle

• Jeon HS
• Moon CS
• Kang SG
• Song KS
• Choi UH

• KMID: 2097595
• DOI: http://doi.org/10.12790/jkssh.2013.18.1.1

Abstract

PURPOSE
The purpose was to describe comparative analysis of the surgical outcome of percutaneous K-wire fixation of bony mallet fingers reduced with towel clip and 18-gauge needle.
METHODS
We analyzed the bony mallet finger patients with more than twelve months follow-up after percutaneous K-wire fixation. The patients were randomly divided into two groups. Eighteen fingers were treated with closed reduction using towel clip and 18 other fingers were treated with closed reduction using 18-gauge needle.
RESULTS
Radiographs showed bony union and no subluxation in all cases after K-wire removal. The average extension lag was 2.8degrees/1.9degrees, and range of motion of distal interphalangeal joint was 70.3degrees/75degrees respectively. According to Crawford's criteria, excellent results were obtained in 9/11 fingers, good results in 8/7 fingers, and poor result in 1/0 finger, respectively.
CONCLUSION
18-gauge needle reduction in percutaneous K-wire fixation is considered less invasive and useful method for treatment of bony mallet finger with comparable results with towel clip reduction.

Keyword

Bony mallet finger; K-wire; Towel clip; 18-Gauge needle

MeSH Terms

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

Figure

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  Fig. 1. A 24-year-old man has a bony mallet finger injury of index finger. (A) The initial anterioposterior and lateral X-ray show displaced dorsal fragment and articular involvement more than 30% without subluxation. (B) Percutaneous pinning with towel clip reduction is performed. (C) At postopertive 12 months, the fracture is united and the patient has a range of motion from 0 to 75 degree.

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  Fig. 2. A 36-year-old man has a bony mallet finger injury of the 4, 5th finger. (A) The initial anteriorposterior and lateral X-ray show a displaced dorsal fragment and articular involvement more than 30% without subluxation. (B) Percutaneous pinning with towel clip reduction is performed. (C) At postoperative 12 months, the fracture is united and the patient has a range of motion from 5 to 78 degree on the 3th finger and 0 to 78 degree on the 4th finger.

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