Mallet Finger

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What is Mallet Finger?

  • Mallet finger is a common athletic injury.
  • Basketball and baseball players routinely experience jammed fingers, but the injury can occur because of a crushing accident on the job, or even because of a cut finger while working in the kitchen.
  • Any rapid motion that jams the tip of a finger against an object can cause a mallet finger.
  • This most commonly occurs at the index or middle fingers.

Mallet Finger Causes

Mallet finger occurs when the outermost (end) joint of the finger is injured. With mallet finger, the tendon on the back of the finger (not the palm side) is separated from the joint it connects. Three types of injuries commonly occur:

  • The tendon is damaged, but no fractures (bone cracks or breaks) are present.
  • The tendon ruptures with a small fracture caused by the force of the injury.
  • The tendon ruptures with a large fracture.

Mallet Finger Symptoms

People with mallet finger may delay seeking medical attention, even though they may be in a great deal of pain, simply because they can still use their hand.

Symptoms of mallet finger may include the following:

  • Pain, tenderness, and swelling at the outermost joint immediately after the injury
  • Swelling and redness soon after the injury
  • Inability to completely extend the finger, but the patient can move it with assistance

When to Seek Medical Care

Contact doctor immediately to evaluate the injury to determine the need for X-ray films, and to repair any deep cuts. The doctor may recommend an appointment with a hand surgeon for further evaluation, splinting, or surgery.

A doctor may instruct a person with mallet finger to go to a hospital's emergency department for further evaluation.

Mallet Finger Diagnosis

X-ray films assist the doctor in determining if the bone is cracked or broken. Imaging studies may also assist the doctor to explore foreign debris in the cut (laceration).

Mallet Finger Treatment

Treatment depends on the severity of the injury. First aid at home includes icing the finger and cleaning and dressing any cuts that may be present. More serious injuries may require stitches or surgery.

Mallet Finger Self-Care at Home

  • Apply ice to the injured finger joint to reduce swelling and tenderness. Wrap ice in a towel; do not apply ice directly to skin. A bag of frozen vegetables wrapped in a towel conforms nicely to the hand.
  • Take care not to injure the finger even more.
  • If a cut is also present, clean the cut under running water for a few minutes, then wrap the finger with clean gauze or a cloth. Apply a moderate amount of pressure to help stop any bleeding.

Medical Treatment

  • If the finger is not broken or cut, or if only a small fracture is present, the doctor will apply a splint to the end of the finger so it remains in the extended position. With a splint, the outermost joint on the injured finger is not bendable, but the rest of the finger is bendable. This splint needs to be worn for at least 6 weeks, perhaps longer, to ensure that the tendon is given the best chance of healing.
  • The doctor will repair any cuts or damage to the skin. And, if necessary, the tendon may be stitched (sutured) to repair it.
  • For pain relief, apply ice to the joint.

Mallet Finger Medications

A variety of over-the-counter and prescription pain relievers may be prescribed depending on the health of the patient, and if any pre-existing medical conditions are present.

Mallet Finger Surgery

When the fracture is large and causes joint damage, the decision may be made to operate on the finger for the best results. A hand specialist or orthopedic surgeon performs this surgery.

Mallet Finger Next Steps

The treating surgeon will monitor the progress of the injury, especially if a deformity in the finger develops.

If a cut is repaired, a follow-up visit to the doctor will be necessary in approximately 10 days to have the sutures removed and to determine if a deformity of the finger is present.

Mallet Finger Prevention

To prevent mallet finger injuries, use caution when participating in activities, including athletic events. To prevent injuries from happening again to the same finger, leave the splint on for the entire time the doctor has recommended.

Mallet Finger Prognosis

Results of treatment of mallet finger injuries vary.

  • Most people regain full function of the finger with no long-term effects.
  • Some people will develop a long-term deformity known as a swan neck, which involves the all of the finger joints. This may require additional surgical correction.
  • For minor mallet finger injuries, splinting and surgery have been shown to have the same results.

Mallet Finger Pictures

This person's index finger has been injured, producing a condition called mallet finger.
This person's index finger has been injured, producing a condition called mallet finger. Click to view larger image.

Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery

REFERENCE:

MedscapeReference.com. Mallet Finger.

Previous contributing coatuhors and editors: Coauthor(s): Steven Nazario, MD, Assistant Professor, Department of Emergency Medicine, Albert Einstein College of Medicine. Editors: Scott H Plantz, MD, FAAEM, Research Director, Assistant Professor, Department of Emergency Medicine, Mount Sinai School of Medicine; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine; Richard Harrigan, MD, Associate Professor, Department of Emergency Medicine, Temple University Hospital, Temple University School of Medicine.

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