Ishiguro et al. describe a closed percutaneous technique for intra-articular mallet finger fractures: an extension block K-wire is placed just proximal to the dorsal fragment under fluoroscopy with the DIP joint in maximum flexion, exploiting joint position to reduce the fragment without direct wire contact. The series covers 86 fractures in 84 patients treated since 1987, with detailed indications, contraindications, technique steps, and complication pitfalls.
When you see a mallet fracture with a fragment ≥1/3 of the articular surface or palmar subluxation of the distal phalanx, the Ishiguro extension block technique offers a percutaneous, fluoroscopy-guided solution under digital block that avoids comminuting the fragment and cuts immobilization time roughly in half compared to open methods — but it must be performed within 5 weeks of injury and is not appropriate for small chip fractures with tendon rupture.
Ishiguro et al. describe a closed percutaneous technique for intra-articular mallet finger fractures: an extension block K-wire is placed just proximal to the dorsal fragment under fluoroscopy with the DIP joint in maximum flexion, exploiting joint position to reduce the fragment without direct wire contact. The series covers 86 fractures in 84 patients treated since 1987, with detailed indications, contraindications, technique steps, and complication pitfalls.
When you see a mallet fracture with a fragment ≥1/3 of the articular surface or palmar subluxation of the distal phalanx, the Ishiguro extension block technique offers a percutaneous, fluoroscopy-guided solution under digital block that avoids comminuting the fragment and cuts immobilization time roughly in half compared to open methods — but it must be performed within 5 weeks of injury and is not appropriate for small chip fractures with tendon rupture.