Abstract
Usually mallet finger is treated conservatively. When the fragment includes one third or more of the articular surface or is displaced enough, operative treatment is indicated. But existing operative treatments are difficult procedures and the results are uncertain. During a two-year period, we used the extension block method. This method is as follows': Under an image intensifier, the operator reduces the fragment by flexing the DIP joint. A Kirschner wire is inserted in the middle phalanx from the dorsal side of the fragment. Finally, the DIP joint is fixed in extension by another Kirschner wire. After 6 weeks fixation, the Kirschner wire is removed and ROM exercise starts. This method follows Ishiguro's method which was presented in 1987. However two points are differrent. In Ishiguro's method, the DIP joint is fixed in flexion for 4 or 5 weeks. In the 10 cases which we treated, the result according to Nanjo's assessment was exellent in 5 cases, good in 4 cases and fair in 1 case. According to Kanie's assessment, the results were 5 exellent cases, 3 good cases, 1 fair case and 1 poor case.
