Tension wire fixation for mallet fracture after extension block pinning failed

Introduction: Various surgical treatments such as extension block pinning have been proposed for acute bony mallet finger. We evaluated the clinical results of tension wire fixation technique for the treatment of nonunion of mallet fracture after failed mallet finger surgery. Materials and methods: Nine male patients were treated with open tension wire fixation for chronic nonunion of mallet fracture after extension block pinning surgery failed. The mean age was 29.3 years (range 18-47). We assessed bone union in simple radiographs. Crawford's and Bischoff functional score was used to assess the functional outcome. Results: The mean follow-up period was 45.8 months (range 18-74). Clinical and radiographic bone unions were achieved in eight of nine patients with average time of 31 days (range 23-41). Mean extension lag at final follow-up was 7° (range 0-25). Four patients showed excellent, three patients showed good and two patients showed fair results on the Crawford's score scale. With Bischoff functional score, all patients were categorized as excellent. Conclusions: Tension wire fixation can be a good second-line reconstructive surgery for the treatment of mallet fracture after extension block failed, so that patients can avoid arthrodesis or complex tendon transfer as a salvage procedure.