The Results of Extension Block Technique for Mallet Fractures Delayed Over Two Weeks

Journal of the Korean Society for Surgery of the Hand 2008;13(1):26-31.
Published online March 1, 2008.

Eun-Sun Moon, Yong-Cheol Park, Myung-Sun Kim, Jong-Seok Kim

2주 이상 지연된 추지 골절에서 신전방지 강선 고정술의 결과

문은선, 박용철, 김명선, 김종석

Abstract

Purpose
We studied the results of extension block technique for mallet fractures delayed over 2 weeks. Materials and Methods: Fifteen cases were retrospectively evaluated. Delayed period was 4.4(2~10) weeks and follow-up duration was 30(4~66) months. In Wehbe、-Schneider classification, they were grouped by 4 type IB, 9 type IIB, 1 type IIC and 1type IIIB. Nine cases were treated by closed reduction and 6 cases after debridement. Six cases were composed of one case delayed for 10weeks, 2 cases for 8 weeks and 3 cases for 4weeks. Result was measured by Crawford classification, bone union and subluxation. Results: In Crawford classification, 10 cases(66.7%) showed the result of ‘Excellent’ or ‘Good’. Mean range of motion was 2.3~80.4。flexion. Clinical result and range of motion had no statistically significant correlation with delayed interval. None showed nonunion, persistent subluxation. Complication rate was 40% including 2 cases of degenerative changes. Conclusion: The treatment by extension block technique showed better results than conservative treatment. We could consider in first this method to start exercise and return to work earlier, because it is simpler than other techniques. Open debridement should be considered for cases delayed over 4weeks.