Arch Hand Microsurg.  2021 Dec;26(4):238-244. 10.12790/ahm.21.0129.

Osteoarthritis after Extension Block Technique for the Bony Mallet Finger

• Koh SH
• Park JH
• Kim JS
• Roh SY
• Lee KJ
• Lee DC

• KMID: 2522621
• DOI: http://doi.org/10.12790/ahm.21.0129

Abstract

Purpose
The purpose of this study is to investigate osteoarthritis after treatment of bony mallet finger using the extension block method.
Methods
A single institutional retrospective review identified 163 patients with bony mallet between January 2012 and July 2020 and received surgical treatment using extension block method. The radiographic examination showed that the fracture line disappeared and a bridging callus was formed and bone union was confirmed. Fractures were classified according to the Tubiana classification method. Demographic data, fracture pattern, postoperative X-ray, and late complications were analyzed. Clinical outcomes were analyzed using Crawford’s criteria.
Results
Surgical treatment was performed within an average of 8.8 days after injury, and the average follow-up period was 11.6 weeks. Osteoarthritis findings were confirmed by joint space narrowing and osteophytes on radiographic examination of 32 out of 163 patients. Age, sex, occupation, location of trauma, operation time, and type of fracture did not affect the osteoarthritis after extension block. Invasion of Kirschner wire (K-wire) to the fracture surface, family history of osteoarthritis, and operation time turned out to have a statistically significant effect on osteoarthritis (p<0.05).
Conclusions
Fracture surface invasion of K-wire and family history of osteoarthritis affect osteoarthritis after treatment of bony mallet.

Keyword

Mallet finger; Osteoarthritis; Extension block

Figure

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  Fig. 1. Extension block method.

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  Fig. 2. Joint space narrowing is observed in the distal interphalangeal joint on X-ray after extension block.

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  Fig. 3. Tubiana classifications. Type I, subcutaneous tendon rupture; type II, bony avulsion at the base of the distal phalanx; type III, fracture >1/3 of the articular surface with volar subluxation; type IV, growth plate fracture.

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  Fig. 4. Kirschner wire invades fracture surface.

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