Bony mallet finger – Ishiguro technique

The Ishiguro technique is indicated for certain avulsion fractures of the base of the distal phalanx, particularly where there is palmar subluxation of the distal interphalangeal joint or a large articular fragment. Performed on an outpatient basis under local anaesthesia, it involves achieving closed reduction of the bone fragment using an extension-block pin, followed by stabilisation of the joint with a second transarticular pin. This minimally invasive technique restores joint congruence whilst minimising trauma to the soft tissues. The pins are usually removed after 6 weeks, after which gradual rehabilitation is commenced to restore mobility whilst ensuring proper bone union.