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：

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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

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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.	王文凱, 武潔, 李仕國, 等. 微型骨錨在新鮮錘狀指畸形治療中的臨床應用. 中國實用醫藥, 2016, 11(1): 90-91.
4.	Salazar Botero S, Hidalgo Diaz JJ, Bena?da A, et al. Review of acute traumatic closed mallet finger injuries in adults. Arch Plast Surg, 2016, 43(2): 134-144.
5.	楊元勛, 王超, 侯俊. 骨性錘狀指治療新進展. 中外醫療, 2015, 34(21): 195-196.
6.	熊革, 中村蓼吾. 石黑法治療伴撕脫骨折的錘狀指. 中國修復重建外科雜志, 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.	王志幫, 徐錦海, 何世鋒. 丹參酮ⅡA磺酸鈉注射液對骨折圍術期患者骨折愈合時間及腫脹度的影響. 實用臨床醫藥雜志, 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.	張變生. 克氏針固定在新鮮閉合性錘狀指的應用. 山西醫藥雜志, 2015, 44(12): 1412-1413.
13.	于志亮, 高順紅, 張凈宇, 等. 克氏針雙夾扣法固定治療遠節指骨背側基底不穩定骨折. 中國修復重建外科雜志, 2015, 29(9): 1186-1187.
14.	寇偉. 經皮導引抽出鋼絲法治療錘狀指的解剖學研究與臨床應用. 廣州: 南方醫科大學, 2014.
15.	安陽. 穿針擠壓固定治療骨性錘狀指的手術方法及效果評價. 長春: 吉林大學, 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.	劉曉賓, 谷右天. 克氏針卡壓固定治療指骨末節基底背側撕脫骨折. 中國醫藥科學, 2013, 3(23): 190-191.
19.	李雯, 齊杰, 藺利劍, 等. 雙克氏針加壓固定法治療骨性錘狀指. 河北醫科大學學報, 2015, 36(4): 472-473.
20.	譚亮. 用可吸收線捆扎固定撕脫骨塊治療骨性錘狀指的解剖與臨床研究. 廣州: 暨南大學, 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. 王文凱, 武潔, 李仕國, 等. 微型骨錨在新鮮錘狀指畸形治療中的臨床應用. 中國實用醫藥, 2016, 11(1): 90-91.
4. Salazar Botero S, Hidalgo Diaz JJ, Bena?da A, et al. Review of acute traumatic closed mallet finger injuries in adults. Arch Plast Surg, 2016, 43(2): 134-144.
5. 楊元勛, 王超, 侯俊. 骨性錘狀指治療新進展. 中外醫療, 2015, 34(21): 195-196.
6. 熊革, 中村蓼吾. 石黑法治療伴撕脫骨折的錘狀指. 中國修復重建外科雜志, 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. 王志幫, 徐錦海, 何世鋒. 丹參酮ⅡA磺酸鈉注射液對骨折圍術期患者骨折愈合時間及腫脹度的影響. 實用臨床醫藥雜志, 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. 張變生. 克氏針固定在新鮮閉合性錘狀指的應用. 山西醫藥雜志, 2015, 44(12): 1412-1413.
13. 于志亮, 高順紅, 張凈宇, 等. 克氏針雙夾扣法固定治療遠節指骨背側基底不穩定骨折. 中國修復重建外科雜志, 2015, 29(9): 1186-1187.
14. 寇偉. 經皮導引抽出鋼絲法治療錘狀指的解剖學研究與臨床應用. 廣州: 南方醫科大學, 2014.
15. 安陽. 穿針擠壓固定治療骨性錘狀指的手術方法及效果評價. 長春: 吉林大學, 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. 劉曉賓, 谷右天. 克氏針卡壓固定治療指骨末節基底背側撕脫骨折. 中國醫藥科學, 2013, 3(23): 190-191.
19. 李雯, 齊杰, 藺利劍, 等. 雙克氏針加壓固定法治療骨性錘狀指. 河北醫科大學學報, 2015, 36(4): 472-473.
20. 譚亮. 用可吸收線捆扎固定撕脫骨塊治療骨性錘狀指的解剖與臨床研究. 廣州: 暨南大學, 2015.

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

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