Open reduction and compression with double Kirschner wires for the treatment of old bony mallet finger

Background The management of old bony mallet fingers is complicated. The aim of the study is to present a new method of open reduction and compression with double Kirschner wires (K-wires) in treating old bony mallet fingers. Methods This was a retrospective analysis of patients with old closed bony mallet fingers treated between June 2013 and December 2016. Complications were observed. The range of motion (ROM) of the DIP joints was measured using a protractor. At the last follow-up, anteroposterior and lateral X-ray of the affected finger was performed, the flatness of the articular surface was scored, and the results were graded using Crawford's criteria. Results Seventeen patients were followed up for 8 (6-19) months. The width of the avulsion fracture block accounted for 25-62% of the articular surface of the distal phalanx. Twelve (70.6%) patients had anterior dislocation of the interphalangeal joint. All patients reported healing at the fracture sites. Healing time was 7.6 +/- 2.1(5-13) weeks. All patients had incision healing of I/Class A. Lateral X-ray showed 13 and four patients had excellent and good articular surface flatness, respectively. At the last follow-up, no traumatic arthritis was present. Only one patient developed mild pain after surgery (VAS score of 3). Postoperative ROM was 76.5 +/- 10.6 degrees (P = 0.0625 vs. healthy side). At the last follow-up, the angle of loss of dorsiflexion was 0-10 degrees (P < 0.0001 vs. baseline). The flexion angle was 50-90 degrees (P = 0.0625 vs. healthy side). Conclusions Open reduction and compression with double K-wires is feasible in treating old bony mallet finger.