Mallet Finger

Introduction

A mallet finger injury occurs when the tip of a finger or thumb is forcefully flexed. This force is what actually injures the tendon that straightens the fingertip joint.  Mallet finger is also referred to as “baseball finger” because it most commonly occurs during the sport of baseball.

Any mallet finger injury causes loss of movement, pain, and swelling. Most mallet finger injuries are treated with a splint. However, in cases of fracture or malalignment, surgery may be necessary to treat the condition.

Finger Anatomy

The fingers are made up of three bones called phalanges, and there are two joints separate these phalanges: the distal interphalangeal (DIP) joints are located near your fingertips, and the proximal interphalangeal (PIP) joints, which are located in the middle of your fingers. Extensor tendons are attached to your phalanges, and these cover the entire finger, allowing you to extend your fingers.

Mallet Finger Causes

A mallet finger injury occurs when the tip of a finger or thumb is forcefully flexed. This force is what actually injures the tendon that straightens the fingertip joint. The force tears the extensor tendon that is attached to the distal phalanx. Mallet finger is also referred to as “baseball finger” because it most commonly occurs during the sport of baseball.

Any mallet finger injury causes loss of movement, pain, and swelling. With enough force, the tendon may remain intact, but a small piece of bone can be pulled away where it attaches to the phalanx. When this happens, it’s called an avulsion fracture.

Mallet Finger Symptoms

A mallet finger injury will most definitely cause pain and swelling at your DIP joint. If you have a mallet finger injury, you will not be able to straighten the end of the injured fingertip. This means that the end of your finger will droop down.

Mallet Finger Diagnosis

The doctor can diagnose a mallet finger injury by examining your finger, and will more than likely ask about how you sustained your injury. X-rays will be used to identify an avulsion fracture, joint malalignment, or associated injuries.

Mallet Finger Treatment

The majority of mallet finger injuries are treated with a splint. You will wear a finger splint uninterrupted for about six weeks. You cannot remove the splint for any amount of time, even if it’s just for a shower. This is because, if the finger splint is removed, even for the shortest amount of time, the treatment is disrupted and the process must start all over. The full time splint schedule is followed by a part time splint wearing schedule for an additional three or four weeks.

Mallet Finger Surgery

Surgery may be necessary for any mallet finger injuries with fractures and joint malalignment.  Surgical hardware, such as pins, wires, and screws, will be used to hold the bones in place while they heal. In rare and very severe cases, the extensor tendon may be tightened or repaired with a graft.

Mallet Finger Recovery

Splinting and surgical treatments are usually followed by physical therapy or hand therapy rehabilitation. A physical or hand therapist will show you exercises to stretch and strengthen your joints. It can take a mallet finger injury several months to heal fully. As with all injuries, healing is an individualized process.

Mallet Finger Prevention

If you believe you have a mallet finger injury, you should elevate your hand above the level of your heart and apply ice intermittently until you can get to your doctor’s office.  You should receive medical attention immediately if you experience bleeding beneath the injured fingernail. Mallet finger injuries that receive prompt treatment tend to have better outcomes.

 

At SPORT, our orthopedic providers can help relieve the pain of a hand or wrist injury and restore your flexibility and range of motion. For an appointment at our Dallas or Frisco office, call (469) 200-2832 today or use our convenient online appointment request form.

Sports Physicians Orthopedics and Rehabilitation of Texas