Mallet finger is one of the most common injuries of the finger, where the fingertip is unable to straighten unless helped up by an external force. There are two main ways this injury happens. Either, the tendon that is responsible for straightening your finger pulls away a small fragment of bone. This is referred to as a bony mallet. Or the tendon itself ruptures, known as a tendinous mallet. While the presentation of both a bony mallet and a tendinous mallet looks similar, their treatment varies slightly.
There are many ways that one can sustain a mallet finger. The most common way to experience a bony mallet finger is by a ball, or sudden force hitting the tip of your finger, causing a sudden bend at the furthest joint. A tendinous mallet finger can be caused by simple daily tasks such as tucking sheets under the bed or even pulling up socks. A cut to the back of the finger towards the fingertip can also cause a tendinous mallet finger, and will often need surgery for repair.
In most cases, mallet finger is a condition that can be diagnosed and treated by your hand therapy practitioner, however, in rare cases, surgery is required to repair the bone or tendon. Your hand therapy practitioner will liaise with your GP if surgery is needed.
Rehabilitation of mallet finger can take between 6-10 weeks. You can expect your hand therapy practitioner to discuss the day-to-day things you need to do between the time of injury and when you recover and assist with methods you can use to ensure this injury isn’t getting too in the way. During the recovery time your hand therapy practitioner will explain and demonstrate ways to self-manage your injury at home.
Sports splints are available and returning to sport while you recover is sometimes appropriate. Assessment of your injury and discussion with your hand therapy practitioner will determine if you are able to return to the court, field, pool or pitch as soon as possible.
Typical bony mallet finger symptoms may include:
Typical tendinous mallet finger symptoms may include:
Your hand therapy practitioner will assess your finger to make a clear diagnosis. It is common that your therapist will:
It is not uncommon for your hand therapy practitioner to request an x-ray to visualise the potential fracture. If the fracture is significant enough it may require surgery.
Treatment for mallet finger usually involves the following:
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“Often people think that this injury is permanent and that their finger will never be straight again. I love getting people’s mallet fingers back to 100% so they can return to doing the things they love!” – Andrew Silaev, Hand Therapy Occupational Therapist at Hoppers Crossing
Lin J, Samora J, 2018, Surgical and Nonsurgical Management of Mallet Finger: A Systematic Review, The Journal of Hand Surgery https://www.jhandsurg.org/article/S0363-5023(17)30045-X/abstract
Bachoura A et al, 2017, A review of mallet finger and jersey finger injuries in the athlete, 2017, NCBI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5344866/
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