Plup Traction Technique for the Operative Treatment of Bony Mallet Finger

Objective: Clinical assessment of the surgical technique with pulp traction for bony mallet finger. Materials and Methods: Eighteen bony mallet finger deformity patients underwent surgery using pulp traction and pull-out wire fixation or 5-0 nylon tendon repair technique from March 2003 to August 2004. The deformities were classified according to Wehbe and Schneider’s classification. Surgical indications included fragment involving more than 1/3 of the articular surface, diastasis more than 3mm, and subluxation of the distal interphalangeal joint irreducible by closed reduction. Results: The results were assessed by Modified Abouna and Brown criteria. Seventeen cases were rated as success and one case was rated failure. Of the Seventeen successful cases, none had extension lag or joint stiffness while all were cosmetically acceptable with patients’satisfaction. One failure case showed extension lag of twenty degrees. There was no case of infection, skin necrosis, joint stiffness, extensor tendon rupture, or wire breakage. There were two cases of minor nail deformity which eventually healed spontaneously and one case with epiphyseal arrest. Conclusion: Pulp traction technique may allow wider surgical field, accurate reduction with lesser complications and acceptable clinical outcomes.ope