What is a Mallet Finger?
On the back (or dorsal) side of your finger, you have a complex arrangement of tendons and ligaments called the extensor mechanism. This is what allows you to straighten your finger. At the base of your fingernail, attached to the bone (distal phalanx), you have your terminal tendon. This tendon allows you to straighten the tip of your finger (DIP joint). An injury to this terminal tendon leads to mallet finger.
In the image below, you can see that the tip joint (DIP joint) is drooping down. Typically with a mallet finger you are unable to actively straighten the tip joint of your finger and it will droop down.
How Does Mallet Finger Occur?
Mallet finger, which is also known as baseball finger, can occur a number of ways. It is typically caused by blunt trauma to the finger, which causes the tendon to tear. The tendon typically tears away from the bone with a small fracture (an avulsion fracture). Mallet finger can also occur with a laceration to the finger. Because the skin on the back (dorsum) of your hand is so thin, the extensor mechanism is commonly injured with lacerations to the back of the hand.
Treatment For Mallet Finger
Will I Need A Splint?
Yes, you will. The treatment for mallet fingers is splinting. Your therapist will make you a splint which will keep your finger straight, and you will have to wear it for 6-8 weeks. Keeping your finger straight for those 8 weeks allows your tendon to heal back into place. After 6 weeks, your therapist may prescribe a weaning schedule for you to begin weaning the splint during the day.
Immobilization is key with this injury healing well. When your therapist tells you that you must keep the splint on all the time, they mean all the time. You will need to remove the splint for cleaning. Even when you take off the splint to clean it or clean your finger, your finger must remain flat on a table. If you bend your finger during these 8 weeks, you can actually re-rupture the tendon. If you allow your finger to bend and it ruptures the healing tendon, you will have to re-start the 8 weeks. We know it sounds extensive, but 8 weeks is a short amount of time to get your finger back to functioning normally.
Don’t Forget to Check Your Skin
The last thing that is really important when you have a mallet finger, is to do skin checks. Take your splint off and inspect your skin. You want to ensure there is no apparent rubbing and that the skin is dry. This way you can keep an eye out for red areas and blisters, and can remain as comfortable as possible during the 8 weeks. A key tip that our therapists find helpful, is that applying baby powder before replacing the splint will help keep your skin dry. This is a key step to prevent blisters from forming and keeping you comfortable.
Have you sustained an injury between or including your shoulder and fingertips? Do you suspect that your workplace environment is causing you pain? If so, you could be a candidate for hand therapy services at LB Hand Therapy in Maryland. Visit our Where to Begin page to become a patient.