The Treatment of Doyle Type 4b Mallet Fractures with Pull-Out Suture and Transarticular Kirschner Wire Fixation Technique

Aim: In this study, we evaluated the results of the pull-out\udsuture and transarticular Kirschner wire fixation technique in the\udtreatment of Doyle type 4b mallet fractures.\udMethods: The study involved 15 patients (10 males, 5 females)\udwith a mean age of 36.3 years (range: 15-55 years) who underwent\udsurgery for mallet fracture between January 2005 and August\ud2013. Following the open reduction, pull-out suture and fixation\udwith transarticular Kirschner wire were performed as the surgical\udmethod. The patients were assessed functionally and clinically\udaccording to the Crawford criteria. The mean follow-up period was\ud39.3 months (range: 6-99).\udResults: Radiographic union was achieved in all patients. None\udof the patients developed infection, skin necrosis, avascular\udnecrosis, nail deformity, and degeneration or subluxation of the\uddistal interphalangeal joint. According to the Crawford criteria, the\udresults were excellent in 12 (80%) patients, good in two (13%)\udpatients and moderate in one (7%) patient. None of the patients\uddeveloped flexion loss and the mean extension loss was 1.5 °C\ud(range: 0-15).\udConclusion: Considering the satisfaction of both the patient\udand the surgeon, we suggest pull-out suturing and transarticular\udKirschner wire application which is a satisfactory surgical method\udin the treatment of Doyle type 4b mallet fractures. (The Medical\udBulletin of Haseki 2015; 53:135-8