What is a mallet finger?

A mallet finger is a disruption of the terminal extensor tendon at the tip of the finger, where the tendon attaches to the bone. It can be either the result of 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 are the most common symptoms of a mallet finger. Oftentimes, patients think they “jammed” their finger.  The finger will also have limited extension at the tip and sometimes it will droop.

How do we diagnose a mallet finger?

A comprehensive history and physical clinical examination will generally be sufficient to see if the tendon is no longer working. A patient’s inability to extend the tip of the finger against gravity or resistance lets us know the tendon is dysfunctional. X-rays are also an important diagnostic tool because they can show fractures if they are present.

How do we treat mallet fingers?

Any mallet finger with a tendon avulsion seen within a month of injury can be treated non-operatively. For this, we use a mallet splint made by a hand therapist; off-the-shelf splints do not work. Mallet splints made by a hand therapist are non-removable, but patients can play sports, shower, and swim in them. They will be worn for six weeks.  Patients that cannot tolerate splinting can opt for a pin to be placed in the finger holding the joint in extension.

If there is a fracture with subluxation of the joint or rotation of the fragment, surgery will be performed to place the piece of bone back in place and reduce the joint.

How are chronic mallet fingers treated?

Unfortunately, there is little success with chronic treatment for mallet fingers. A fusion of the end joint is performed for highly symptomatic patients.

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