Mallet finger is an injury to the end of the finger which causes it to bend inwards towards the palm. This happens when the tendon connecting the muscle to the finger bone is stretched or torn.
The finger generally becomes painful and swollen. In some cases, the tendon doesn’t tear but a small fragment of bone breaks off the finger where the tendon is attached which can make the affected area exquisitely painful. You will usually lose the ability to extend or straighten the end part of the finger and it will be stuck in a flexed or kinked position. Redness, swelling and tenderness of the skin around the end of the finger are common for three or four months after injury but usually settle eventually.
The injury occurs normally when the fingertip is forcefully bent while being actively flexed e.g. hit by a ball being caught.
Your Physiotherapist will ask for a full history of the injury and will carry out a full physical examination so that a fast and accurate diagnosis can be made. If mallet finger is diagnosed, your Physiotherapist may advised getting an X-ray to determine whether the injury is bony or tendon. The NHS recommend going to a minor injuries unit as soon as possible if mallet finger is suspected as it may need a splint.
The splint puts the finger in full extension or slight hyper-extension which brings together the tendon to promote optimal healing and protection. Patients should follow the advice given to remain in the splint continuously for 6 to 8 weeks, followed by two weeks of night time application only.
If the finger becomes bent again by accident the 6-8 weeks should start again in the splint for 6-8 weeks. It is very important that the end joint does not bend during the splint treatment period. If the finger is still dropped the splint will be kept on in place continuously for a further two weeks.
When the splint can come off for rehabilitation to commence, it is important to keep wearing the splint overnight and during moderate use of the hand for at least a further two weeks. It is also essential to keep the rest of the hand moving especially the joint below the splint.
Your Physiotherapist will design a personalised and progressive exercise plan to help restore as much movement and function possible. It may take several months for the finger to function well. Exercise is important to regain motion and strength and regular re-assessment with your Physiotherapist will ensure you are making suitable progress and that your current exercises are working towards the desired outcomes.