Comparison of clinical and radiological results of surgical treatment with extension block pinning method and suture anchor in Mallet Fingernail surgical treatment

Aim: To compare the clinical and radiological results of the extension block pinning method (stoppıng pin) and suture anchor surgical treatment techniques applied in the treatment of bone mallet finger fractures and to reveal the advantages and disadvantages of these techniques and which method is more effective. Patients and Methods: In this study, a total of 53 patients with mallet finger fractures Doyle type 4b and 4c diagnosed between 2013 and 2023 were analyzed using a retrospective method. In 37 of these patients, extension block pinning method was used, and in 16 of these patients suture anchor fixation method, which is an open surgical technique, was used. The study was conducted in a single center with a single surgical team. DOYLE classification, which is generally accepted in mallet finger fractures, was used as fracture classification. The Q-DASH scoring system and Crawford criteria were used to evaluate the preoperative and postoperative radiologic measurements, union status, postoperative VAS pain scores, and clinical and functional outcomes of the upper extremities. Results: The mean age of the 53 patients included in the study was 29 years. The minimum age of the patients was 18 years and the maximum age was 58 years. The mean age of patients who underwent extension block pinning was 30.5 years, while the mean age of patients who underwent suture anchoring was 34.9 years. The type of injury was found to be simple fall 52.8%, battery 15.1%, sports injury 13.2%, crush 13.2% and work accident 5.7%. According to Doyle classification, 71.7% were type 4b and 28.3% type 4c. In the extension block pinning patient group, 40.5% had excellent results and 32.4% had good results according to Crawford criteria; in the suture anchor patient group, 12.5% had excellent results and 50% had good results. . When we looked at the general patient population, the most commonly affected finger was the 5th finger with a rate of 45.3%. The complication rate was 2.7% in the extension block pinning patient group and 31.3% in the suture anchor patient group. The Q-DASH score was 2.00±2.70 in the extension block pinning patient group and 3.13±3.48 in the suture anchor patient group. Conclusion: In our study, both surgical techniques had good clinical and functional results. However, the extension block pinning method was found to be more advantageous than the suture anchor technique because it is a more noninvasive technique, less complications, less implant cost and relatively more excellent results