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 injury occurs normally when the fingertip is forcefully bent while being actively flexed e.g. hit by a ball being caught.
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.
The NHS recommend going to a minor injuries unit as soon as possible if mallet finger is suspected as it may need a splint. An X-ray may be taken to determine whether the injury is bony or tendon.
Routine management is for the injured finger to be placed in 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.
At Pure, our Physiotherapists are highly skilled to provide assessment and treatment of Mallet finger. It may take several months for the finger to become fully functional. 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.
Changes to the appearance of the joint are common and some are unable to fully straighten the joint. The finger may not be exactly the same as it was before the injury, but overall it should function well. Exercise is important to regain motion and strength.