PMC7276571_01
Technique of delta wiring. (a)Correct reduction with slight flexion with suspension. (b)Insertion of the Kirschner wire (0.8mm) from the dorsal side and make a hook at the dorsal end. (c)Advance the Kirschner wire (0.8mm) with the counterforce until the hook compresses the fracture fragment. (d)Cut the Kirschner wire at ventral end with 2cm longor less and make another hook. (e)Insert another Kirschner wire (1mm) along long axis of distal phalanx intramedullary,make an acute angle and another hookleaving 5mm of distance from the previous Kirschner wire. (f)Hang the twohooks and apply dressing over them to prevent further injury.
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F1
Hang the two hooks and apply dressing over them to prevent further injury (Fig.1a-f), allowing the DIP joint to have free movement.
Pre-operative, intraoperative, and post-operative X-rays.Anteroposteriorand lateral viewof pre-operative, intraoperative, and 7 weeks followed up X-rays after K-wire removal showing bony mallet fracture with fracture fragment more than 1/3of the articular surface of distal phalanx was fixed with delta wiring and complete union at final followed up X-rays.
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F2
Lateral and posteroanterior plain radiographs were taken pre-operative, intraoperative, and weekly postoperatively (Fig. 2).
Range of motion of the distal interphalangeal joint. (a)Full extension with delta wire construct. (b)Full flexion with delta wire construct.
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F3
Active range of motion exercises was initiated immediately after the operation (Fig.3a and b).