Surgical treatment of mallet finger fractures by tension band technique.

A retrospective review was performed of 19 patients with irreducible mallet finger fractures after failed splinting. The patients were treated with open reduction and a tension band technique. Follow-up results were available for 18 patients (95%) at an average 8.2 years postoperatively. Eighty-nine percent of patients had no clinical mallet deformity, troublesome pain, or major functional disability. Distal interphalangeal range of motion averaged 1 degree hyperextension to 69 degrees flexion. All fractures healed with a congruent articular surface. Minor nonmechanical complications were encountered in 11% of cases in which a suture was used as the tension band material. Successful treatment may thus be achieved surgically in this select subset of mallet finger fractures when this technique is employed.