A new surgical treatment for mallet finger deformity: deepithelialised pedicled skin flap technique.

Abstract

Mallet finger, well-known also as drop finger or baseball finger, is a frequent deformity after extensor tendons injury in the fingers. Although numerous nonoperative or operative techniques have been used in managing this deformity, the treatment still remains a debated subject. Starting from 1996, 121 fingers in 118 patients with neglected deformity or unsuccessful splinting older than 10 days underwent surgical treatment. In 101 patients a tendinous mallet finger was present, and in 20 patients a bony mallet finger. After immobilising the distal interphalangeal (DIP) joint at 0° extension with a Kirschner wire, the extensor tendon was repaired by using a dorsal deepithelialised skin flap reinserted transosseous. The DIP joint was immobilised for 6 weeks in a thermoplastic splint, and after that it was gradually weaned from the immobilisation. An overnight splint was used for 4-6 weeks after starting the mobilisation. The mean follow-up period was 10 months (range: 3-120 months). An excellent result in 89 fingers and a good result in 32 fingers were obtained, according to Crawford's evaluation criteria. This method seems to be a new reliable alternative in the treatment of chronic mallet finger.