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Hand News

Pinning Down an Effective Treatment for Mallet Fractures

Doctors from the Mayo Clinic and the Naval Medical Center report good results after surgery for mallet fractures of the fingers. A mallet injury tears the extensor tendon from the tip of the finger. This tendon extends, or straightens, the fingertip.

A mallet fracture occurs when the tendon actually pops off a piece of bone from the end of the finger where the tendon attaches. Mallet injuries involving the tendon or bone can result in a permanently bent fingertip. A torn tendon may only require the use of a splint that keeps the finger straight, allowing the tendon to heal. Serious tendon tears and those involving a fracture usually need surgery.

This study examines a surgical method called extension block pinning. Doctors use wires and pins to put the bone back together and hold the joint in one position. It takes about 35 days for the bone to heal. The pins are taken out when an X-ray shows new bone bridging both sides of the fracture line. The fracture site must be pain-free and not tender. Exercises begin to regain range of motion after the pins are removed. A special splint is worn for two to three weeks to protect the joint.

The authors report that this surgery is a good treatment for large mallet fractures of the fingers. Risks and complications with other methods are reduced by using this approach. Patients showed quick healing with good range of motion.


Eric P. Hofmeister, MD, et al. Extension Block Pinning for Large Mallet Fractures. In The Journal of Hand Surgery. May 2003. Vol. 28A. No. 3. Pp. 453-459.

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