Modification of the pull-in suture technique for mallet finger.

Abstract

Mallet finger injuries are common and involve disruption of the terminal extensor mechanism overlying the distal interphalangeal joint. Many operative techniques have been advocated. The pull-in suture technique is a useful surgical procedure for the treatment of mallet finger. Although this procedure allows accurate realignment of the tendon-bone, it has limitations. To eliminate these limitations, we present here a modification of the pull-in suture technique. From January 2008 to October 2009, 10 mallet fingers treated using this modification were included in this prospective study. Of the patients, 6 were men and 4 were women. Their ages at surgery ranged from 19 to 41 years, with a mean of 29.7 years. Of these, 1 involved the thumb; 2, the index finger; 2, the middle finger; 3, the ring finger; and 2, the little finger. The length of time from the injury to surgery ranged from 1 to 20 days (mean, 6.3 days). According to Doyle's classification, there were 1 type II, 4 type III, and 5 type IVb cases. At a mean follow-up of 15.4 (range, 13-22) months, all patients were pain free. The average final active range of motion of the distal interphalangeal joint was 60 degrees (range, 50-70 degrees). Using Crawford's criteria, 2 patients were graded as excellent, 7 as good, and 1 was graded as fair. Neither pin tract infections nor skin compressive ulcers occurred. The modification eliminated or reduced the incidence of complications when compared with the original method. This technique should be considered when treatment of a mallet deformity using the pull-in suture technique is planned.