Excellent functional recovery after Kirschner-wire extension blocking technique for displaced closed bony mallet finger injuries; results of 36 cases


bony mallet injury ; extension blocking technique ; functional outcome ; patient-rated-wrist/hand evaluation

Published online: Jul 15 2019

Armelle J.A. Meershoek , Jort Keizer , Roderick M. Houwert , Mark van Heijl , Detlef van der Velde , Philippe Wittich

From the department of Surgery, St Antonius Hospital Nieuwegein, Utrecht, The Netherlands


Bony mallet finger injuries comprise 30% of all mallet injuries. Operative treatment of bony mallet fingers injuries still remains controversial. The aim of this study was to describe the k-wire extension blocking technique and the functional results using the PRWHE questionnaire.

A single center retrospective observational cohort of 36 patients was defined between January 2010 and December 2015. Inclusion criteria for this study were acute fractures with 1) persistent displacement of more than 3 mm in extension splint, 2) palmar subluxation of the distal phalanx or 3) fracture fragments consisting of more than one third of the joint surface. According to the PRWHE questionnaire, excellent results were observed with a mean follow up period of 32 months of all patients. Two patients developed a clinically relevant superficial wound infection and one patient developed a nail deformity. In conclusion, the k-wire extension blocking technique is safe and results in excellent mid-term functional outcome.