Extension Block Pinning Using a Small External Fixator for Mallet Finger Fractures

PurposeTo describe surgical outcomes of a series of patients with bony mallet fingers treated by a modified extension blocking technique with external fixation.MethodsWe developed an external fixator that was attached to the extension block pin. Dorsal rotation of the dorsal fragment during reduction was prevented with 1 or 2 additional pins abutted on the fragment through the fixator. We reviewed 12 consecutive patients with mallet finger fractures who were treated surgically with the external fixator. The mean age of the patients was 33 years (range, 15–60 y).ResultsRotation of the fragment during reduction was well controlled in all patients. All fractures united at an average of 5 weeks after surgery. Average extension lag was 2° and active flexion was 74°. No patient reported pain at a final follow-up of 4 months (range, 3–8 mo). According to the Crawford rating scale, 10 patients were classified as excellent and 2 were good.ConclusionsOur modification of the extension block method prevented dorsal rotation of the fragment during reduction and resulted in early union.Type of study/level of evidenceTherapeutic IV.