Mallet Finger
Mallet Finger
A mallet finger is a disruption of the terminal extensor tendon at the tip of the finger. It is a disruption of the where the tendon attaches to the bone. It can be either from a tendon avulsion (ripping off the bone) or a fracture of the bone (mallet fracture).
What are the symptoms of a mallet finger?
Pain and swelling commonly occur. Often patients think they “jammed” their finger. Sometimes there is very little pain. The finger will have limited extension at the tip. Sometimes the finger will droop.
How do we diagnose a mallet finger?
A simple clinical exam will let us know if the tendon is not working. The inability of the tip of the finger to extend against gravity or resistance lets us know the tendon is dysfunctional. X-rays are important because they can show fractures.
How do we treat mallet fingers?
Any finger with a tendon avulsion seen within a month of injury can be treated non-operatively. We use a mallet splint made by a hand therapist. Off the shelf, splints do not work. These splints are non-removable. One can play sports, shower and swim in them. They will be on for 6 weeks. Those that cannot tolerate splinting can opt for a pin to be placed holding the joint in extension. It will be removed in 6 weeks as well.
If there is a fracture with subluxation of the joint or rotation of the fragment surgery is performed to place the piece back and reduce the joint.
How are chronic mallet fingers treated?
There is little success with chronic treatment for mallet fingers. The fusion of the end joint is performed for symptomatic patients.
