Mallet Finger

Anatomy of the Finger

The finger joint is a hinge-joint that allows bending and straightening of the fingers. Each finger is composed of 3 phalanges joined by 2 interphalangeal joints (IP joints). The joint near the base of the finger is called the proximal IP joint (PIP joint), and the joint near the tip of the finger is called the distal IP joint (DIP joint).

What is a Mallet Finger?

A mallet finger is a condition where the end of the finger is bent and does not straighten.

How does Mallet Finger Occur?

Mallet finger occurs when the extensor tendon at the back of the finger is damaged.

Causes of Mallet Finger

Mallet finger occurs due to sports activities (such as baseball) or other activities that cause a direct and forceful impact on the fingers that jam the finger.

Signs and Symptoms of Mallet Finger

The main symptoms of mallet finger are drooping of the finger at the distal joint, pain and swelling around the area and limited range of motion at the joint.

Impact of Mallet Finger

The injury either causes a rupture of the extensor tendon without a bone fracture or rupture with a small or large bone fracture.

Diagnosis

The diagnosis of mallet finger involves a physical examination and obtaining an X-ray of the injured finger. In some cases, other imaging techniques such as MRI scan may be ordered.

Untreated Mallet Finger

If left untreated, mallet finger can develop into a finger joint deformity referred to as a swan neck deformity.

Treatment for Mallet Finger

Generally, mallet finger can be treated non-surgically using specially designed splints that immobilise the finger and promote natural healing. In cases of fracture, complete bone healing may take 6-8 weeks, followed by physiotherapy for strengthening. In severe cases that don’t respond to conservative treatment and when your fingers are required to perform occupational tasks, surgery is recommended. Internal splints can be placed surgically with metal pins in the affected bones. The pins can be removed after 6 weeks of healing.

If you fail to achieve adequate relief, you will be recommended surgery that involves repairing the torn tendon. If the mallet finger involves a fracture of the bone fragment, then it can be stabilised and fixed using pins and a special K-wire.

Postoperative Care following Mallet Finger Surgery

After mallet finger surgery, you will be recommended for physiotherapy or occupational therapy for flexibility and strengthening exercises.

Risks and Complications of Mallet Finger Surgery

The common risks and complications associated with mallet finger surgery include:

• Avascular necrosis (bone death from lack of blood supply)
• Infection
• Stiffness
• Nail-bed damage
• Chronic tenderness