Pin orthosis extension block pinning versus conservative treatment for doyle type 4B mallet fractures
By
Kemal Arda Col
Onur Demirsu
Mahmud Aydın
Serkan Surucu
Murat Yilmaz
Dogan Atlihan
June 23, 2026
Clinical Scorecard: Comparison of Pin Orthosis Extension Block Pinning and Conservative Management for Doyle Type 4B Mallet Finger Fractures
At a Glance
Category Detail
Condition Mallet Finger Fractures Key Mechanisms Injury characterized by inability to actively extend the fingertip due to extensor tendon rupture or avulsion fracture. Target Population Adults aged 18-65 with acute Doyle type 4B mallet fractures. Care Setting Orthopedics and Traumatology outpatient clinic and emergency department.
Key Highlights
Mallet finger results from hyperflexion or axial loading of the DIP joint. Conservative treatment is recommended for closed injuries without DIP joint subluxation. Surgical techniques include Ishiguro’s extension block pinning and pin-orthosis extension-block pinning. The study compares PO-EBPT with conservative treatment for clinical and radiographic outcomes. Inclusion criteria: acute mallet fracture with 20-50% articular surface involvement. Guideline-Based Recommendations
Diagnosis
Diagnosis based on clinical examination and radiographic assessment. Management
Conservative management with splint immobilization for closed injuries. Surgical intervention for cases with significant fracture involvement. Monitoring & Follow-up
Regular follow-up visits to assess fracture alignment and healing. Risks
Potential complications include infection, nail deformity, and joint stiffness. Patient & Prescribing Data
Patients aged 18-65 with acute mallet fractures.
Conservative treatment involves a Stack orthosis for DIP joint stabilization.
Clinical Best Practices
Ensure strict compliance with splint use in conservative management. Perform regular radiographic evaluations to monitor healing. Consider surgical options for fractures involving a larger portion of the articular surface. Related Resources & Content
