MALLET FINGER INJURIES
By Laura Carter - Practitioner of Hand Therapy
A ‘mallet finger’ is a common name for an injury caused when the thin tendon that straightens the end of your finger (the extensor tendon) is damaged.
Typically a mallet finger occurs with forcible bending of the tip of the finger. This force bends the finger further than it is intended to go and consequently tears the tendon.
As a result, you are no longer able to straighten the tip of the finger on your own.
Types of Mallet Injury
Mallet finger injuries can be ‘bony’ or ‘tendinous’.
Bony mallets occur when the bone at the tip of the finger where the tendon attaches breaks and both the tendon and the bone pull away.
This is called an avulsion injury.
If a mallet is purely tendinous, this means the tendon is torn away from the bone but the bone itself is left intact.
Differentiating between bony and tendinous mallets can be important for determining timeframes for treatment.
Cause of Mallet Finger?
Some common causes of mallet finger include:
Ball strike to the tip of the finger
Crushing injury or accident at work
Cutting of finger while working in the kitchen
Any rapid motion that jams the tip of a finger against an object
Occasionally, even a minor force such as tucking in a bed sheet or pulling up your breeches will cause a mallet finger!
Symptoms of Mallet Finger
The most obvious symptoms of a mallet finger is the ‘drooping’ of the tip of your finger with an inability to straighten it into a neutral position. In some cases, this may be the only symptom of injury. Other symptoms can include:
Pain - this usually is minimal and settles very quickly
Occasional blood clots under the nailbed
How do I fix a Mallet Finger?
A large number of mallet finger injuries can be treated by a Hand Therapist without surgery. Treatment involves splinting the finger straight or slightly beyond straight for a period of 6-8 weeks (depending on whether the injury is bony or tendinous).
If your finger bends at all during this time, it can set back the healing process. Your Hand Therapist will instruct you on how to wear your splint and maintain skin hygiene without allowing the finger to drop.
Following this period of immobilisation, most people can then begin to wear the splint less and less frequently until it is no longer needed at all. Your therapist will also provide exercises to regain full motion and strength of the affected finger.
What can I do to make it better?
If you suspect you have sustained a mallet finger injury, there are steps you can take to reduce pain and protect the injury:
Apply ice immediately
Elevate the hand above the level of the heart
Make a temporary splint that straightens your finger
One way to do so is to place a popsicle stick along the underside of your finger. Use strapping tape to secure the stick so your finger is held tightly against it in a straightened position
Seek medical attention within a week after injury
you will need to get a splint professionally constructed by a hand therapist to ensure adequate healing