Mallet Finger

Mallet finger is a type of injury that occurs when the tendon that straightens the tip of the finger (extensor tendon) is stretched or torn, typically at the base of the distal phalanx.

Causes and Risk Factors

• Direct blow to the tip of the finger, such as from a ball or other object
• Sudden, forceful bending of the finger, such as when trying to catch an object
• Weakened or damaged tendons due to age, injury, or certain medical conditions
• Participating in sports that involve catching or throwing, such as basketball, football, or baseball

Symptoms

• Pain and swelling at the base of the distal phalanx
• Inability to straighten the tip of the finger
• Drooping or sagging of the fingertip
• Bruising or bleeding under the nail
• Limited range of motion in the affected finger

Types of Mallet Finger

• Bony mallet finger: involves a fracture of the distal phalanx, which can be further classified into:
  • Non-displaced fracture: the bone remains in place
  • Displaced fracture: the bone is out of place
• Tendinous mallet finger: involves a tear or rupture of the extensor tendon, without a fracture
• Rupture of both bone and tendon: a combination of a fracture and a tendon injury

Diagnosis

Diagnosis is typically made through a physical examination and medical history. Imaging tests such as X-rays may be ordered to confirm the diagnosis and rule out other conditions.

Treatment

• Conservative management: includes immobilization of the finger in a splint or cast, pain management with medication, and physical therapy to maintain range of motion
• Surgical intervention: may be necessary for more severe injuries, such as displaced fractures or ruptures of both bone and tendon
• Follow-up care: regular follow-up appointments with a healthcare provider to monitor healing progress and adjust treatment as needed

Complications and Prognosis

If left untreated, mallet finger can lead to chronic pain, stiffness, and limited range of motion in the affected finger. With proper treatment, most people can expect a full recovery, although some may experience residual symptoms or limitations.