Vol. 6, Issue 1, Part A (2024)

Extension-block pinning is a popular surgical treatment method, the fixation wires can cause iatrogenic nail bed injury, osteoarthritis. The objective of this study was to determine the result of Extension block wiring technique in mallet fractures with fracture fragment involving more than one-third of the distal phalanx articular surface. The authors are reporting 14 cases of mallet fractures treated with Extension block wiring with good functional and radiologic outcomes. Radiologic outcomes were evaluated on the basis of postoperative and follow-up x-rays and functional outcomes were evaluated using Crawford’s criteria. 14 patients (11 males, 3 female) with a mean age of 28.5 years (Range, 20 to 33 y) were included. The mean time between the injury and surgery was 6 days (Range, 3 to 7 d), and the mean follow-up period was 1.4 months (range, 8 to 18 mo). Radiographic bone union was achieved in all patients within an average of 6.4 weeks (Range, 5 to 7 wk). Atth final follow-up, the distal interphalangeal joint had an average degree of flexion of 74 degrees (Range, 70 to 76 degrees) and an average extension deficit of 5.60 (Range, 0 to 8 degrees). According to Crawford’s criteria, 8 patient had excellent results and 4 patients had good results, and 2 patients with fair result. No patient reported pain at the final follow-up with a visual analoge scale score mean of 0.6 (Range, 0 to 2). Satisfactory clinical and radiological outcome were obtained with the Extension block wiring technique.