Mallet Finger is the name attributed to the condition that causes a deformity in the finger when the tendon responsible for straightening out the finger (the extensor tendon) is damaged.
Mallet finger, often experienced by athletes, occurs when a ball or other similar object strikes the tip of a finger or the thumb, and forcibly bends it. When this happens, the force of this tears the extensor tendon, and the tip of the finger or thumb is no longer able to straighten. In some cases, a small fragment of bone can come away with the torn tendon, which is called an avulsion injury.
It is possible that this tear or displacement can occur outside of sports related activities, with minor activities such as tucking a bed sheet.
There are three types of injuries that can occur with damage to the extensor tendon, with varying degrees of pain and different treatment required. The three kinds are:
- When the tendon is damaged internally, but no fractures or external injuries are present
- When the tendon is torn, and a small fracture occurs as a result of the force
- When the tendon ruptures and the force hitting it also causes a significant fracture
Causes of Mallet Finger
Mallet finger can occur for a number of reasons, the most common or well-known being sports-related injuries. Mallet finger is often caused by a ball or other instrument striking the tip of an outstretched finger with considerable force. This injury is most often seen in ball-related sports, giving the condition its alternative name of ‘baseball finger’.
Mallet finger can also be caused by activities related to the work force, operating machinery, moving heavy objects and even slicing a finger in a cooking incident.
Symptoms of Mallet Finger
Most symptoms will be experienced at the time of the injury. When the injury is caused by a blunt force hitting the finger, the patient will most likely experience a great deal of pain in the tip of their finger.
Other symptoms can be any of the following:
- If the tendon is damaged or torn, the tip of the finger will not be able to straighten out
- Swelling and redness will occur immediately after the injury
- There will be a lot of pain and tenderness at the joint
- There is likely to be bruising on the finger
- Sometimes blood collects underneath the nail, causing the nail to eventually fall off
Immediate Care for Mallet Finger
When the injury strikes, it is important that ice be immediately applied to the finger, to reduce swelling as soon as possible. While the ice is being applied, the patient should elevate their arm in order to reduce blood flow to the affected area. The purpose of this is to prevent swelling and infection which can easily occur following a mallet finger injury.
If the injury does not cause major inconvenience to regular hand usage, patients can often choose to simply continue self treating and not seek medical advice. However, it is important to be attended to by a doctor within a week. If the fingernail is bleeding or there is blood underneath the fingernail it is important to be seen by a doctor immediately. If this occurs, it is possible there has been a fracture or a cut in the nail bed and opens up the finger for infection.
Diagnosis and Treatment of Mallet Finger
When a mallet finger injury occurs, it is necessary and important to have a doctor evaluate the condition quickly, to ensure that the finger regains full functionality in the long term.
Upon physical examination of the injuries sustained, the doctor will ask his or her patient to attempt to straighten out the tip of the finger without assistance.
A doctor will often arrange an X-Ray to determine whether any fragments of bone have also detached with the tearing of the tendon and assess whether the joint is properly aligned.
Splints are most often the only treatment necessary for the healing of a mallet finger. Different kinds of splints can be worn to help the process. A splint needs to be worn for between six to eight weeks.The purpose of the splint is to straighten out the finger and allow the tendon to be repaired.
It is not uncommon for patients to wear the splint full time for eight weeks and then part time in the following three or four weeks. When the splint is fully removed, it is possible that full extension and free movement in the finger will not be regained immediately. A surgeon or a hand therapist will assist a patient by showing them exercises that will help free the movement.
The doctor will decide on the best method of treatment following the X-Ray and assessing the damage. If there is a large fracture in the finger or if the joint is out of place, a doctor will recommend surgery to repair the injuries sustained. In situations like this, a surgeon will use pins to hold the bones in place while the fracture heals.
Following the surgery, a surgeon or hand therapist will re-evaluate the injury, to ensure that healing is occurring correctly and that all joints are aligned. Where hand therapy is necessary, it will be recommend for patients to ensure full use of the finger is able to be regained.
Treatment for Mallet Finger
Our goal at OSMI is to provide our patients quality, cutting-edge orthopedic treatments, both surgical and non-surgical. If you or someone you know sustains an injury to the finger that matches the description and symptoms of mallet finger, it is important to be seen by a doctor, and at the earliest possible availability to ensure the injuries sustained do not have any permanent effects on the the patient. Please submit an online appointment request or contact our office at 817-529-1900.
