Comparison of wire versus Nylon in Bonny-Mallet Finger treated with pull-out surgery

Abstract Introduction: Zone I extensor tendon lesion accompanies an avulsion fracture of the bone insertion. A common complication of traditional pull-out is the necrosis of the site of the button in the finger pad. Zhang described an alternative way of anchoring the cerclage to the Kirschner Wire (K-wire) to relieve the pressure in the finger pad. He describes the use of wire cerclage, for fracture reduction. The objective of this paper is to perform a comparison between wire and nylon using Zhang pull-out technique. Material and methods: We performed a cohort study comparing Nylon versus Wire in Zhang technique. Comparing cosmetic satisfaction, stiffness, residual pain, and Crawford scale. Results: When comparing the outcomes between both groups, we found no statistical difference in cosmetic satisfaction (p = 0.285), stiffness (p = 0.460), and residual pain (p =1.000), overall complications (p = 1.000), or Crawford scale (p = 1.000). We only found a significant statistical difference in pain when removing the cerclage, being greater in Group B (p = 0.008). Conclusions: We found no significant outcome difference between nylon and wire cerclage. However, at the time of removing it, patients experience less pain.

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Bibliographic Details
Main Authors: Rendón-Medina,Marco A., Hanson-Viana,Erik, Mendoza-Vélez,María A., Vargas-Rocha,Jesús M., Rojas-Ortiz,Jorge A., Hernandez-Ordoñez,Rubén, Vazquez-Morales,Hecly L., Pacheco-López,Ricardo C.
Format: Digital revista
Language:English
Published: Academia Mexicana de Cirugía A.C. 2022
Online Access:http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2444-054X2022000800023
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Summary:Abstract Introduction: Zone I extensor tendon lesion accompanies an avulsion fracture of the bone insertion. A common complication of traditional pull-out is the necrosis of the site of the button in the finger pad. Zhang described an alternative way of anchoring the cerclage to the Kirschner Wire (K-wire) to relieve the pressure in the finger pad. He describes the use of wire cerclage, for fracture reduction. The objective of this paper is to perform a comparison between wire and nylon using Zhang pull-out technique. Material and methods: We performed a cohort study comparing Nylon versus Wire in Zhang technique. Comparing cosmetic satisfaction, stiffness, residual pain, and Crawford scale. Results: When comparing the outcomes between both groups, we found no statistical difference in cosmetic satisfaction (p = 0.285), stiffness (p = 0.460), and residual pain (p =1.000), overall complications (p = 1.000), or Crawford scale (p = 1.000). We only found a significant statistical difference in pain when removing the cerclage, being greater in Group B (p = 0.008). Conclusions: We found no significant outcome difference between nylon and wire cerclage. However, at the time of removing it, patients experience less pain.