Mallet finger (also known as drop finger) is an injury to the extensor tendon situated over the top of the joint at the end of the finger.
The torn, ruptured or snapped tendon is no longer able to straighten the tip joint, resulting in its characteristic bent appearance.
Real-life causes
“I was playing cricket and the ball hit the tip of my finger.”
“My child crushed their finger in a door.”
“I cut my finger in the kitchen.”
“I was making my bed and tucking in the sheets.”
Diagnosis
If your finger has painful swelling, bruising and tenderness as a result of your injury and you are unable to straighten it, it’s best to get treatment as soon as possible. Make an appointment with your GP who can refer you to one of our hand therapists.
Occasionally, a fragment of bone where the tendon attached is pulled off during the injury. If this has occurred, your diagnosis will be bony mallet injury.
Treatment
During your initial consultation, your therapist will fit a custom splint to keep the joint stabilised. In most cases, these tendons tend to mend themselves with this treatment.
You’ll need to keep your splint on 24 hours a day until it has sufficiently healed. The healing process could take around 6-8 weeks. After 6-8 weeks of full time splinting you’ll slowly begin the process of weaning out of your splint.
Your hand therapist will show you how to properly support your finger and remove the splint safely so you can clean and wash your hand. When you have your splint on, you won’t be able to bend the tip of your finger. However, it’s crucial you keep your other joints moving.
If an x-ray reveals the fragment of bone that was attached to your torn tendon is large or has moved out of position, further medical intervention will be needed. Your hand therapist will work closely with your GP, who may refer you to a hand specialist.
Recovery
It’s important that you wear your splint as advised during the 6-8 week period. If you don’t and you‘ve been flexing the joint, you may have to start the treatment process again.
The typical recovery period from mallet finger is 8 weeks, but it can take close to 12 weeks for your finger to return to its normal strength. Your therapist will give you exercises to help you regain motion – it’s important you follow them.
Do you need surgery for mallet finger?
In the rare cases where surgery is required, the procedure involves repairing the torn tendon or, if the bone fragment is fractured, stabilisation with pins and wire.
Post-operative care
You’ll have an appointment with your hand therapist 2-3 days after your surgery. They’ll remove the dressing and replace it with a custom splint.
After another 10-14 days, you’ll have your sutures removed.
Possible complications of mallet finger
- Ongoing pain and stiffness
- If left untreated, mallet finger can lead to a swan neck deformity