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Journal of the Korean Society for Surgery of the Hand 2009;14(1):18-22.
Published online March 1, 2009.
Modified Extension Block Technique for Large Mallet Fracture
Hong Kee Yoon, Byoung Min Kim, Soo Kyoon Rah
Department of Orthopedic Surgery, Sunchunhyang University College of Medicine, Seoul, Korea. honzi@hanmail.net
Abstract
Purpose
To evaluate retrospectively the clinical results of modified extension block technique for large mallet fracture. MATERIALS AND METHODS: From May 2006 to August 2007, we reviewed 16 patients who got surgery with large mallet fracture. Surgical indications included fractures involving more than 33% of the articular surface or fractures associated with subluxation of the distal interphalangeal joint. The average age was 32.6 years old. The average time from injury to surgery was 10days. We performed modified extension block technique in all patients. The pins were removed between 5 to 6 weeks when we confirmed bone union by radiology. Function outcomes were determined by using the Crawford criteria.

Results
The average fracture fragment size was 52% of the joint surface. Average time to fracture union was 5.4weeks(4.5~7.5weeks). At a mean follow-up of 8.2months(5-13months) average extension loss was 3degrees (0-10degrees )and average flexion was 77degrees (60-85degrees ). According to Crawford classification, 81.3% of paitents had excellent or good results. There were 2 nail deformity.

Conclusion
Modified extension block technique can make up for the weak points of traditional techique in the treatment for large mallet fracture.
 


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