Application of absorbable anchor combined with Kirschner wire in reconstruction of extension function of old mallet finger_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHENG Dongdong ,  ZHOU Zhengbing , LIN Zixuan , LIU Hui , YANG Fan , WANG Jin , GUO Shang

Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, 200233, P. R. China;

Corresponding author：

ZHOU Zhengbing, Email: zhouzhengbing@yeah.net

Keywords：

Old mallet finger; absorbable anchor; Kirschner wire; insertion reconstruction of extensor tendon

DOI：

10.7507/1002-1892.202212039

Video：

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Objective To investigate the feasibility and effectiveness of absorbable anchor combined with Kirschner wire fixation in the reconstruction of extension function of old mallet finger. Methods Between January 2020 and January 2022, 23 cases of old mallet fingers were treated. There were 17 males and 6 females with an average age of 42 years (range, 18-70 years). The cause of injury included sports impact injury in 12 cases, sprain in 9 cases, and previous cut injury in 2 cases. The affected finger included index finger in 4 cases, middle finger in 5 cases, ring finger in 9 cases, and little finger in 5 cases. There were 18 patients of tendinous mallet fingers (Doyle type Ⅰ), 5 patients were only small bone fragments avulsion (Wehbe type ⅠA). The time from injury to operation was 45-120 days, with an average of 67 days. The patients were treated with Kirschner wire to fix the distal interphalangeal joint in a mild back extension position after joint release. The insertion of extensor tendon was reconstructed and fixed with absorbable anchors. After 6 weeks, the Kirschner wire was removed, and the patients started joint flexion and extension training. Results The postoperative follow-up ranged from 4 to 24 months (mean, 9 months). The wounds healed by first intention without complications such as skin necrosis, wound infection, and nail deformity. The distal interphalangeal joint was not stiff, the joint space was good, and there was no complication such as pain and osteoarthritis. At last follow-up, according to Crawford function evaluation standard, 12 cases were excellent, 9 cases were good, 2 cases were fair, and the good and excellent rate was 91.3%. Conclusion Absorbable anchor combined with Kirschner wire fixation can be used to reconstruct the extension function of old mallet finger, which has the advantages of simple operation and less complications.

Citation： CHENG Dongdong, ZHOU Zhengbing, LIN Zixuan, LIU Hui, YANG Fan, WANG Jin, GUO Shang. Application of absorbable anchor combined with Kirschner wire in reconstruction of extension function of old mallet finger. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(4): 443-446. doi: 10.7507/1002-1892.202212039 Copy

1.	de Jong JP, Nguyen JT, Sonnema AJ, et al. The incidence of acute traumatic tendon injuries in the hand and wrist: a 10-year population-based study. Clin Orthop Surg, 2014, 6(2): 196-202.
2.	Huang Y, Wu K, Shi H, et al. Kirscner wire fixation versus suture anchor technique for mallet finger: A meta-analysis. Medicine (Baltimore), 2021, 100(11): e24996. doi: 10.1097/MD.0000000000024996.
3.	张玉军, 巨积辉, 赵强, 等. 掌长肌腱折叠联合抽出钢丝法治疗陈旧性锤状指. 中华手外科杂志, 2020, 36(1): 52-54.
4.	苑福升, 张巨, 孙鸿斌. 掌长肌腱腱片移植重建终腱治疗陈旧性锤状指畸形. 中华手外科杂志, 2006, 22(3): 149-150.
5.	Aksan T, Öztürk MB, Özçelik B. A single K-wire to prevent poor outcomes in closed soft-tissue mallet finger management due to patient non-compliance. Arch Orthop Trauma Surg, 2021, 141(4): 693-698.
6.	李伟峰, 张敬标, 安庆, 等. 一期闭合复位双克氏针弹性加压固定治疗Wehbe-SchneiderⅠB型及ⅡB型骨性锤状指. 中国修复重建外科杂志, 2022, 36(4): 400-404.
7.	Handoll HH, Vaghela MV. Interventions for treating mallet finger injuries. Cochrane Database Syst Rev, 2004, (3): CD004574. doi: 10.1002/14651858.CD004574.pub2.
8.	Suzuki T, Iwamoto T, Sato K. Surgical treatment for chronic tendon mallet injury. J Hand Surg (Am), 2018, 43(8): 780.e1-780.e5.
9.	Wang WC, Hsu CE, Yeh CW, et al. Functional outcomes and complications of hook plate for bony mallet finger: a retrospective case series study. BMC Musculoskelet Disord, 2021, 22(1): 281. doi: 10.1186/s12891-021-04163-2.
10.	Batıbay SG, Akgül T, Bayram S, et al. Conservative management equally effective to new suture anchor technique for acute mallet finger deformity: A prospective randomized clinical trial. J Hand Ther, 2018, 31(4): 429-436.
11.	Khera B, Chang C, Bhat W. An overview of mallet finger injuries. Acta Biomed, 2021, 92(5): e2021246. doi: 10.23750/abm.v92i5.11731.
12.	杨晨松, 邵钦, 陈春华, 等. 微型锚钉治疗腱性锤状指的疗效分析. 中华手外科杂志, 2017, 33(4): 269-270.
13.	施海峰, 芮永军, 吴柯, 等. 陈旧性锤状指的手术治疗. 中华手外科杂志, 2017, 33(4): 264-265.
14.	赵志明, 邢丹谋, 任东, 等. Thompson法治疗伴鹅颈畸形的陈旧性锤状指. 中华手外科杂志, 2017, 33(2): 81-83.
15.	刘斌, 胡学斌, 陶红波, 等. Thompson法与抽出钢丝法重建伸肌腱止点治疗陈旧性锤状指的效果比较. 中国当代医药, 2020, 27(23): 88-91.
16.	Lin JS, Samora JB. Surgical and nonsurgical management of mallet finger: A systematic review. J Hand Surg (Am), 2018, 43(2): 146-163.

1. de Jong JP, Nguyen JT, Sonnema AJ, et al. The incidence of acute traumatic tendon injuries in the hand and wrist: a 10-year population-based study. Clin Orthop Surg, 2014, 6(2): 196-202.
2. Huang Y, Wu K, Shi H, et al. Kirscner wire fixation versus suture anchor technique for mallet finger: A meta-analysis. Medicine (Baltimore), 2021, 100(11): e24996. doi: 10.1097/MD.0000000000024996.
3. 张玉军, 巨积辉, 赵强, 等. 掌长肌腱折叠联合抽出钢丝法治疗陈旧性锤状指. 中华手外科杂志, 2020, 36(1): 52-54.
4. 苑福升, 张巨, 孙鸿斌. 掌长肌腱腱片移植重建终腱治疗陈旧性锤状指畸形. 中华手外科杂志, 2006, 22(3): 149-150.
5. Aksan T, Öztürk MB, Özçelik B. A single K-wire to prevent poor outcomes in closed soft-tissue mallet finger management due to patient non-compliance. Arch Orthop Trauma Surg, 2021, 141(4): 693-698.
6. 李伟峰, 张敬标, 安庆, 等. 一期闭合复位双克氏针弹性加压固定治疗Wehbe-SchneiderⅠB型及ⅡB型骨性锤状指. 中国修复重建外科杂志, 2022, 36(4): 400-404.
7. Handoll HH, Vaghela MV. Interventions for treating mallet finger injuries. Cochrane Database Syst Rev, 2004, (3): CD004574. doi: 10.1002/14651858.CD004574.pub2.
8. Suzuki T, Iwamoto T, Sato K. Surgical treatment for chronic tendon mallet injury. J Hand Surg (Am), 2018, 43(8): 780.e1-780.e5.
9. Wang WC, Hsu CE, Yeh CW, et al. Functional outcomes and complications of hook plate for bony mallet finger: a retrospective case series study. BMC Musculoskelet Disord, 2021, 22(1): 281. doi: 10.1186/s12891-021-04163-2.
10. Batıbay SG, Akgül T, Bayram S, et al. Conservative management equally effective to new suture anchor technique for acute mallet finger deformity: A prospective randomized clinical trial. J Hand Ther, 2018, 31(4): 429-436.
11. Khera B, Chang C, Bhat W. An overview of mallet finger injuries. Acta Biomed, 2021, 92(5): e2021246. doi: 10.23750/abm.v92i5.11731.
12. 杨晨松, 邵钦, 陈春华, 等. 微型锚钉治疗腱性锤状指的疗效分析. 中华手外科杂志, 2017, 33(4): 269-270.
13. 施海峰, 芮永军, 吴柯, 等. 陈旧性锤状指的手术治疗. 中华手外科杂志, 2017, 33(4): 264-265.
14. 赵志明, 邢丹谋, 任东, 等. Thompson法治疗伴鹅颈畸形的陈旧性锤状指. 中华手外科杂志, 2017, 33(2): 81-83.
15. 刘斌, 胡学斌, 陶红波, 等. Thompson法与抽出钢丝法重建伸肌腱止点治疗陈旧性锤状指的效果比较. 中国当代医药, 2020, 27(23): 88-91.
16. Lin JS, Samora JB. Surgical and nonsurgical management of mallet finger: A systematic review. J Hand Surg (Am), 2018, 43(2): 146-163.

Chinese Journal of Reparative and Reconstructive Surgery

Application of absorbable anchor combined with Kirschner wire in reconstruction of extension function of old mallet finger

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