EFFECTIVENESS OF MODIFIED Ishiguro TECHNIQUE WITH STRENGTHENING PRESSURE IN TREATMENT OF BONY MALLET FINGERS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANGWenping , LIWenbin , LIUZeyuan , WEIJian , LIBo , CHENZhi , GUOZhenye ,  LIANGBingsheng

Department of Orthopedics, the Second Hospital, Shanxi Medical University, Taiyuan Shanxi, 030001, P.R.China;

Corresponding author：

LIANGBingsheng, Email: Liangbs707@aliyun.com

Keywords：

Bony mallet finger; Ishiguro technique; Phalangeal fracture; Improved operation method

DOI：

10.7507/1002-1892.20160143

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of modified Ishiguro technique with strengthening pressure in the treatment of bony mallet finger by comparing with the traditional Ishiguro technique. Methods Between May 2013 and May 2015, 31 cases of bony mallet finger were treated with traditional Ishiguro technique in 16 cases (control group) and with modified Ishiguro technique in 15 cases (improved group, the two Kirschner wires were bound, which were used to fix the distal interphalangeal joint and blocking avulsion fracture block in the classical Ishiguro technique, and play a continuous elastic compression). Difference was not significant in gender, age, cause of injury, injury finger, and the time from injury to operation between 2 groups (P > 0.05). Results The wound healing was delayed in 2 cases of the control group and 1 case of the improved group, and the other patients obtained healing by first intension. The follow-up time was 8-23 months (mean, 11 months) in the improved group and was 9-24 months (mean, 12 months) in the control group. Bending deformation of the Kirschner wire occurred in 2 cases of the control group, obvious separation was found between fracture fragment and the distal phalanx; after manual reduction, brace was used to fix, and distal interphalangeal arthritis occurred during follow-up. The fracture healing time was (6.8±0.8) weeks in the control group, and was (5.7±1.5) weeks in the improved group. There was significant difference in the healing time between 2 groups (t=-2.439, P=0.021). At last follow-up, according to Crawford criteria, the results were excellent in 9 cases, good in 4 cases, fair in 2 cases, and poor in 1 case with an excellent and good rate of 81.25% in the control group; the results were excellent in 10 cases, good in 3 cases, and fair in 2 case with an excellent and good rate of 86.67% in the improved group. There was no significant difference in excellent and good rate between 2 groups (Z=-0.636, P=0.525). Conclusion Compared with traditional Ishiguro technique, the modified Ishiguro technique with strengthening pressure in treatment of bony mallet finger can facilitate the fracture healing, reduce Kirschner wire loosening and deformation, and decrease the rates of operation failure and complications.

Citation： ZHANGWenping, LIWenbin, LIUZeyuan, WEIJian, LIBo, CHENZhi, GUOZhenye, LIANGBingsheng. EFFECTIVENESS OF MODIFIED Ishiguro TECHNIQUE WITH STRENGTHENING PRESSURE IN TREATMENT OF BONY MALLET FINGERS. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(6): 705-708. doi: 10.7507/1002-1892.20160143 Copy

1.	Alla SR, Deal ND, Dempsey IJ. Current concepts: mallet finger. Hand (N Y), 2014, 9(2): 138-144.
2.	Kreuder A, Pennig D, Boese CK, et al. Mallet finger: a simulation and analysis of hyperflexion versus hyperextension injuries. Surg Radiol Anat, 2016, 38(4): 403-407.
3.	王文凯, 武洁, 李仕国, 等. 微型骨锚在新鲜锤状指畸形治疗中的临床应用. 中国实用医药, 2016, 11(1): 90-91.
4.	Salazar Botero S, Hidalgo Diaz JJ, Benaïda A, et al. Review of acute traumatic closed mallet finger injuries in adults. Arch Plast Surg, 2016, 43(2): 134-144.
5.	杨元勋, 王超, 侯俊. 骨性锤状指治疗新进展. 中外医疗, 2015, 34(21): 195-196.
6.	熊革, 中村蓼吾. 石黑法治疗伴撕脱骨折的锤状指. 中国修复重建外科杂志, 2004, 18(2): 138-141.
7.	Shimura H, Wakabayashi Y, Nimura A. A novel closed reduction with extension block and flexion block using Kirschner wires and microscrew fixation for mallet fractures. J Orthop Sci, 2014, 19(2): 308-312.
8.	王志帮, 徐锦海, 何世锋. 丹参酮ⅡA磺酸钠注射液对骨折围术期患者骨折愈合时间及肿胀度的影响. 实用临床医药杂志, 2015, 19(15): 151-153.
9.	Crawford GP. The molded polythene splint for mallet finger deformities. J Hand Surg (Am), 1984, 9(2): 231-237.
10.	Lee YH, Kim JY, Chung MS, et al. Two extension block Kirschner wire technique for mallet finger fractures. J Bone Joint Surg (Br), 2009, 91(11): 1478-1481.
11.	Lee SK, Kim KJ, Yang DS, et al. Modified extension-block K-wire fixation technique for the treatment of bony mallet finger. Orthopedics, 2010, 33(10): 728.
12.	张变生. 克氏针固定在新鲜闭合性锤状指的应用. 山西医药杂志, 2015, 44(12): 1412-1413.
13.	于志亮, 高顺红, 张净宇, 等. 克氏针双夹扣法固定治疗远节指骨背侧基底不稳定骨折. 中国修复重建外科杂志, 2015, 29(9): 1186-1187.
14.	寇伟. 经皮导引抽出钢丝法治疗锤状指的解剖学研究与临床应用. 广州: 南方医科大学, 2014.
15.	安阳. 穿针挤压固定治疗骨性锤状指的手术方法及效果评价. 长春: 吉林大学, 2013.
16.	Neuhaus V, Thomas MA, Mudgal CS. Type IIb bony mallet finger: is anatomical reduction of the fracture necessary? Am J Orthop (Belle Mead NJ), 2013, 42(5): 223-226.
17.	Miranda BH, Murugesan L, Grobbelaar AO, et al. PBNR: percutaneous blunt needle reduction of bony mallet injuries. Tech Hand Up Extrem Surg, 2015, 19(2): 81- 83.
18.	刘晓宾, 谷右天. 克氏针卡压固定治疗指骨末节基底背侧撕脱骨折. 中国医药科学, 2013, 3(23): 190-191.
19.	李雯, 齐杰, 蔺利剑, 等. 双克氏针加压固定法治疗骨性锤状指. 河北医科大学学报, 2015, 36(4): 472-473.
20.	谭亮. 用可吸收线捆扎固定撕脱骨块治疗骨性锤状指的解剖与临床研究. 广州: 暨南大学, 2015.

1. Alla SR, Deal ND, Dempsey IJ. Current concepts: mallet finger. Hand (N Y), 2014, 9(2): 138-144.
2. Kreuder A, Pennig D, Boese CK, et al. Mallet finger: a simulation and analysis of hyperflexion versus hyperextension injuries. Surg Radiol Anat, 2016, 38(4): 403-407.
3. 王文凯, 武洁, 李仕国, 等. 微型骨锚在新鲜锤状指畸形治疗中的临床应用. 中国实用医药, 2016, 11(1): 90-91.
4. Salazar Botero S, Hidalgo Diaz JJ, Benaïda A, et al. Review of acute traumatic closed mallet finger injuries in adults. Arch Plast Surg, 2016, 43(2): 134-144.
5. 杨元勋, 王超, 侯俊. 骨性锤状指治疗新进展. 中外医疗, 2015, 34(21): 195-196.
6. 熊革, 中村蓼吾. 石黑法治疗伴撕脱骨折的锤状指. 中国修复重建外科杂志, 2004, 18(2): 138-141.
7. Shimura H, Wakabayashi Y, Nimura A. A novel closed reduction with extension block and flexion block using Kirschner wires and microscrew fixation for mallet fractures. J Orthop Sci, 2014, 19(2): 308-312.
8. 王志帮, 徐锦海, 何世锋. 丹参酮ⅡA磺酸钠注射液对骨折围术期患者骨折愈合时间及肿胀度的影响. 实用临床医药杂志, 2015, 19(15): 151-153.
9. Crawford GP. The molded polythene splint for mallet finger deformities. J Hand Surg (Am), 1984, 9(2): 231-237.
10. Lee YH, Kim JY, Chung MS, et al. Two extension block Kirschner wire technique for mallet finger fractures. J Bone Joint Surg (Br), 2009, 91(11): 1478-1481.
11. Lee SK, Kim KJ, Yang DS, et al. Modified extension-block K-wire fixation technique for the treatment of bony mallet finger. Orthopedics, 2010, 33(10): 728.
12. 张变生. 克氏针固定在新鲜闭合性锤状指的应用. 山西医药杂志, 2015, 44(12): 1412-1413.
13. 于志亮, 高顺红, 张净宇, 等. 克氏针双夹扣法固定治疗远节指骨背侧基底不稳定骨折. 中国修复重建外科杂志, 2015, 29(9): 1186-1187.
14. 寇伟. 经皮导引抽出钢丝法治疗锤状指的解剖学研究与临床应用. 广州: 南方医科大学, 2014.
15. 安阳. 穿针挤压固定治疗骨性锤状指的手术方法及效果评价. 长春: 吉林大学, 2013.
16. Neuhaus V, Thomas MA, Mudgal CS. Type IIb bony mallet finger: is anatomical reduction of the fracture necessary? Am J Orthop (Belle Mead NJ), 2013, 42(5): 223-226.
17. Miranda BH, Murugesan L, Grobbelaar AO, et al. PBNR: percutaneous blunt needle reduction of bony mallet injuries. Tech Hand Up Extrem Surg, 2015, 19(2): 81- 83.
18. 刘晓宾, 谷右天. 克氏针卡压固定治疗指骨末节基底背侧撕脱骨折. 中国医药科学, 2013, 3(23): 190-191.
19. 李雯, 齐杰, 蔺利剑, 等. 双克氏针加压固定法治疗骨性锤状指. 河北医科大学学报, 2015, 36(4): 472-473.
20. 谭亮. 用可吸收线捆扎固定撕脱骨块治疗骨性锤状指的解剖与临床研究. 广州: 暨南大学, 2015.

Previous Article
ENDOSCOPIC CALCANEOPLASTY FOR Haglund’s DEFORMITY WITH HINDFOOT PAIN
Next Article
CLASSIFICATION AND SURGICAL TREATMENT OF MUCOUS CYSTS OF DISTAL INTERPHALANGEAL JOINT

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF MODIFIED Ishiguro TECHNIQUE WITH STRENGTHENING PRESSURE IN TREATMENT OF BONY MALLET FINGERS

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content