Mallet finger is an injury to the end of the finger that causes it to bend inwards toward the palm. The end of the finger can’t be straightened because the tendon connecting the muscle to the finger bone is stretched or torn. People with mallet fingers may delay seeking medical attention—even though they are in significant pain—simply because they can still use their hands. They assume the injury isn’t serious and hesitate to get it checked out, which can delay the healing process. You should seek treatment for a mallet finger right away. An excellent place to start would be getting a thorough exam and workup from the orthopedic hand specialists at Advanced Orthopedics in Denver, Parker, and Aurora, Colorado. It’s your hand. You need to trust where you put it.
Mallet finger, known as drop finger or baseball finger, is a common injury often a result of unpreventable accidents. This injury can happen to anyone when an unyielding object (like a ball) strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. This causes damage to the extensor tendon. It can affect any of the fingers of the hand, although most mallet finger injuries affect the dominant hand. If a mallet finger is left untreated, the finger can become stiff. Or the finger may develop a swan neck deformity, where the joint bends the wrong way. No matter how hard one tries to straighten it with their hand muscles, it just won’t go. Someone with a mallet finger might be able to push it straight with the other hand but then let go, and the end just drops down again.
WHAT IS MALLET FINGER?
Since mallet finger is a tendon injury, it may help to have an understanding of tendons. A tendon is like a rope made up of collagen (protein) fibers that attach muscles to bones. Mallet finger involves a tendon called the terminal extensor tendon that straightens the end joint of the finger (called the DIP joint). With mallet finger, the tendon on the back of the finger (not the palm side) is separated from the muscles it connects.
Three types of injuries commonly lead to mallet finger:
- The tendon is damaged, but no fractures 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 frequently occurs in sports such as baseball, basketball, or football, where it is easy to reach to catch a hard ball, and it hits the extended fingertip. However, other incidents like crushing a finger in a door or cutting a finger while working in the kitchen can result in a mallet finger. It can even affect older women during activities as simple as putting on socks or making a bed.
After the pain of the initial injury:
- An inability to straighten the fingertip
- A detached fingernail
- Redness under the fingernail bed
Treating a mallet finger is generally straightforward if treated quickly. Splinting is the first-line treatment for a mallet finger. Even though the injury might appear deceptively minor, it can require a period of 6-8 weeks of splinting the finger dead straight 24/7 for the tendon to heal. After this initial period, the splint must be worn for a few more weeks allowing the joint to move and exercise. Unfortunately, this is how long it takes for the injury to heal correctly, but fortunately, the outcomes are usually excellent.
If a mallet finger is left untreated, or the splinting treatment isn’t adhered to exactly as the surgeon suggests, there are several risks. One is called swan neck deformity—due to the changes in the biomechanics of the finger, the second joint (PIP joint) can begin to hyperextend. If this hyperextension is severe enough, the joint can lock itself in hyperextension and can’t be bent without help. If this occurs, it can become permanent. Other risk factors for mallet fingers are osteoarthritis and stiffness.
WHEN IS SURGERY INDICATED?
The more complex the injury is, the more surgery is generally recommended. These include injuries where:
- The joint is not aligned correctly
- The tendon requires a graft of tendon tissue from someplace else on your body
- The doctor needs to surgically insert hardware such as pins, wires, screws, or plates to keep the fingertip straight until the tendon is healed
- A large tendon fracture is causing tendon damage.
GETTING THE RIGHT DIAGNOSIS. GETTING THE RIGHT DOCTOR.
When it comes to mallet finger, each individual is different. After a thorough examination of the injury, further imaging tests such as an X-ray, MRI, or ultrasound might be ordered to determine the true extent of the injury to the tendon and bone. Because the splinting regimen can be so intense, and because of the amount of time it takes to heal a mallet finger, it’s imperative to start with an exact diagnosis like you’ll get from the orthopedic specialists at Advanced Orthopedics in Denver, Parker, and Aurora, Colorado. Healing can be an extensive process which means you want someone there for you all the way until you’re able to get back to sports or just life, in general, and regain the function of the finger. You won’t find any professionals more caring and supportive. Advanced Orthopedics. You’ve got to hand it to them. Book an appointment now.