Surgical treatment of chronic mallet finger: report of two operative techniques

Abstract

Introduction: Mallet finger is a common injury of the extensor tendon insertion causing an extension lag of the distal interphalangeal (DIP) joint. In an acute case, non-operative treatment with splinting serves favourable outcome. However, in a chronic condition, surgical intervention is a preferable treatment. We present 2 cases of chronic mallet finger treated using 2 different surgical techniques.

Presentation of case: A 42-year-old male came with extension lag on DIP joint of left index finger, which had lasted for 2 months after being bitten by a cat. The DIP was slightly radially deviated. We performed Snow’s method of reconstruction by splitting the lateral band on the radial side and transferred it through tunnel on distal phalanx onto the lateral band on ulnar side. The second patient, a 19-year-old male came with extension lag of DIP joint of left little finger, which had lasted for 6 months after trauma. We performed terminal extensor tendon plication. Post operatively, for both cases, we held the DIP joint with K-wire in 0 degree of extension The K-wire was removed 6 weeks after the operations and subsequently finger exercises were made actively and passively.

Discussion: Chronic mallet finger has many different techniques of surgical interventions. The aim of surgery was to improve finger function, rebalance the extensor mechanism of finger, relieve pain, and improve cosmetic appearance.

Conclusion: Variety of surgical options are available for chronic tendinous mallet fingers. Methods of terminal extensor tendon plication and Snow’s reconstruction both offer a satisfying clinical and functional outcome.