A new surgical treatment for mallet finger deformity: deepithelialised pedicled skin flap technique

Injury. 2013 Mar;44(3):351-5. doi: 10.1016/j.injury.2013.01.013. Epub 2013 Jan 20.

Abstract

Introduction: Mallet finger, well-known also as drop finger or baseball finger, is a frequent deformity after extensor tendons injury in the fingers. Although numerous nonoperative or operative techniques have been used in managing this deformity, the treatment still remains a debated subject.

Patients and methods: Starting from 1996, 121 fingers in 118 patients with neglected deformity or unsuccessful splinting older than 10 days underwent surgical treatment. In 101 patients a tendinous mallet finger was present, and in 20 patients a bony mallet finger. After immobilising the distal interphalangeal (DIP) joint at 0° extension with a Kirschner wire, the extensor tendon was repaired by using a dorsal deepithelialised skin flap reinserted transosseous. The DIP joint was immobilised for 6 weeks in a thermoplastic splint, and after that it was gradually weaned from the immobilisation. An overnight splint was used for 4-6 weeks after starting the mobilisation.

Results: The mean follow-up period was 10 months (range: 3-120 months). An excellent result in 89 fingers and a good result in 32 fingers were obtained, according to Crawford's evaluation criteria.

Conclusion: This method seems to be a new reliable alternative in the treatment of chronic mallet finger.

MeSH terms

  • Adolescent
  • Adult
  • Bone Wires
  • Finger Injuries / diagnostic imaging
  • Finger Injuries / physiopathology
  • Finger Injuries / surgery*
  • Finger Joint / diagnostic imaging
  • Finger Joint / physiopathology
  • Finger Joint / surgery*
  • Fracture Fixation, Internal* / methods
  • Hand Deformities, Acquired / diagnostic imaging
  • Hand Deformities, Acquired / physiopathology
  • Hand Deformities, Acquired / surgery*
  • Humans
  • Middle Aged
  • Radiography
  • Range of Motion, Articular
  • Recovery of Function
  • Splints
  • Surgical Flaps / blood supply*
  • Tendon Injuries / diagnostic imaging
  • Tendon Injuries / physiopathology
  • Tendon Injuries / surgery*
  • Treatment Outcome