Percutaneous fixation of mallet fractures by the "umbrella handle" technique

Over a period of 8 years, 48 fingers with mallet fractures of Wehbe and Schneider Types 1 and 2, subtypes B and C, were treated in 31 men and 17 women of mean age 42 (range 17-61) years. The fractures included 5 Type 1 subtype B, 2 Type 1 subtype C, 23 Type 2 subtype B and 18 Type 2 subtype C fractures. The technique used consisted in passing a K-wire percutaneously from dorsal to volar and pinning the fracture fragment while leaving the distal interphalangeal joint free to allow immediate postoperative mobilisation. Fracture splintage was removed at 6 weeks. The results at 8 weeks, which remained unchanged at 12 months in 46 fingers, were assessed as excellent in 11, good in 35 and fair in two cases by the Crawford rating system. One case of pin track infection required early removal of the pin.