gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Causes of procedural failures of closed reductions using an extension-block pin for bony mallet finger

Meeting Abstract

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  • presenting/speaker Taku Suzuki - Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
  • Takuji Iwamoto - Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
  • Noboru Matsumura - Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
  • Shigeki Nagura - Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
  • Ruriko Iigaya - Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
  • Kazuki Sato - Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1181

doi: 10.3205/19ifssh0148, urn:nbn:de:0183-19ifssh01484

Veröffentlicht: 6. Februar 2020

© 2020 Suzuki et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: This retrospective study evaluated procedural failures of closed reductions using an extension-block Kirschner-wire (K-wire) for bony mallet finger.

Methods: A total of 132 patients who underwent a closed reduction for bony mallet finger in a procedure using an extension-block K-wire technique were radiographically assessed. Radiographs were used to evaluate: (1) postoperative displacement of the reduction before or after K-wire removal and (2) inaccurate reduction of the fragment immediately after surgery. The causes of procedural failure and bone union were evaluated using plain anteroposterior and lateral radiographs and medical records of the intraoperative findings.

Results and Conclusions: Out of 132 patients, 17 patients of mean age 48 (range, 17 to 71) years with procedural failure were enrolled in this study. Displacement of the reduction before and after K-wire removal occurred in 7 and 6 cases, respectively. Inaccurate reduction immediately after surgery occurred in 4 cases. The most common cause of procedural failure was inaccurate insertion of the K-wire to fix the distal interphalangeal (DIP) joint (8 cases) followed by inaccurate insertion of the extension-block pin (5 cases). Two patients underwent a second operation. All patients who underwent a single operation had bone union regardless of the displacement of the reduction or inaccurate reduction of the fragment.

Caution should be exercised during the reduction and fixation when an extension-block K-wire is used for a closed reduction procedure.