Mallet Finger

What is it?

Mallet fingers are common sports related injuries causing a bent posture of the DIP joint. It is often caused by a ball-strike or jammed fingertip causing a forced flexion of the extended fingertip. 

The mallet finger injury causes the extensor tendon to tear from the bone (soft tissue mallet) or causes a fracture of the distal phalanx with the extensor tendon attached to it (bony mallet). An X-Ray should be performed to rule out the small number of injuries that need referral to a hand surgeon.

Treatment

Most mallet injuries can be treated without surgery by full time splinting for 8 weeks. Splints can be fitted at a pharmacy, but I encourage referral to a hand therapist to make a well fitted custom splint and provide education about how to keep the finger straight for 8 weeks and give you the best chance of healing.

In a small number of cases, the DIPJ can fall out of position (subluxate) and require surgery. Surgery often involves pinning the bone fragment and joint in position while the bone fragment heals.(1) Wires are placed through the skin and left prominent for 6 weeks before removal in the rooms. 

What are the long term effects?

If left untreated, mallet injuries can lead to a permanent drooping of the end of the finger. In some people, this can also lead to a PIP joint swan neck deformity. 

What are the risks of surgery?

  • Infection
  • Stiffness
  • Loss of fracture or joint position

Commonly Associated Trauma

Fractures

References

  1. Wada, T., and T. Oda. “Mallet Fingers with Bone Avulsion and DIP Joint Subluxation.” The Journal of Hand Surgery, European Volume 40, no. 1 (January 2015): 8–15. https://doi.org/10.1177/1753193414554772.
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Dr Avanthi Mandaleson

Specialist Hand & Upper Limb Surgeon​
(BMedSci, MBBS, FRACS, FAOrthA)

For all appointments please call (03) 9456 9077