Okyar ALTAŞ, Tuğçe Nur ŞAHİN, Eren ŞAHİN, Serdar TOY, Zafer Volkan GÖKÇE, Sidar ÖZTÜRK
Hand and Microsurgery - 2026;15(1):17-25
Objective: To compare the functional outcomes of the delta frame (DF) and extension block pinning (EBP) techniques in the surgical treatment of mallet finger injuries and to develop a new classification system for outcome assessment. Methods: Twenty-eight patients who underwent surgery for mallet finger between 2022 and 2025 were retrospectively evaluated in this study. 10 patients underwent DF fixation, and 18 underwent EBP. Functional outcomes were assessed using the Mallet-modified fingertip injury score (M-FIOS), Michigan Hand Questionnaire (MHQ), and Crawford classification. Demographic data, surgical duration, quantity of fluoroscopies, and complications were documented. Results: There were no differences in age, sex, affected side, and injury type between groups (p>0.05). The EBP group had a higher chronic case rate (38.9% vs. 0.0%; p=0.030). The DF group had a longer operation time (68.0+/-10.9 vs. 36.7+/-16.8 min; p<0.001) but achieved a higher overall mean MHQ score (83.3 vs. 65.6; p<0.001). Significant differences favoring the DF group were noted in MHQ subscales for daily living (p=0.028), work performance (p<0.001), pain (p=0.005), aesthetics (p=0.002), and satisfaction (p=0.003). All DF patients had excellent Crawford classification results. Complications occurred in 16.7% of EBP patients and 20.0% of DF patients. Conclusion: Despite longer surgical times, the DF technique for mallet finger treatment results in better patient satisfaction, pain control, and functional outcomes compared to EBP. It is a reliable alternative, especially for acute bony mallet cases. Nevertheless, we consider that the outcomes of the M-FIOS classification are not adequately definitive for the purposes of evaluation.
