Mallet finger, also known as baseball finger or drop finger, is a condition where the tendon that straightens the tip of the finger or thumb is torn or ruptured, causing the fingertip to droop or bend downward.

Common Symptoms

The primary symptoms of mallet finger include:

• Pain, swelling, and bruising around the fingertip
• Inability to straighten or extend the fingertip without assistance
• Drooping or bending of the fingertip
• Redness or blood under the fingernail
• Difficulty gripping objects

Cause & Anatomy

Mallet finger is typically caused by a forceful impact or jamming of the fingertip, which can rupture or tear the extensor tendon or break the bone that straightens the finger. This injury is common in sports like baseball, basketball, and volleyball, where a ball or other object can strike the fingertip.

The key anatomical structure involved in mallet finger is the extensor tendon, which attaches to the base of the distal phalanx (the bone in the fingertip) and allows the finger to straighten or extend. When this tendon is torn or ruptured, or the bone is broken, the fingertip cannot be actively extended.

Diagnosis

Mallet finger is typically diagnosed through a physical examination, where the healthcare provider will observe the drooping fingertip and test the patient’s ability to straighten the finger actively. X-rays or other imaging tests may be ordered to check for fractures or other associated injuries.

Prevention

To prevent mallet finger injuries, it is recommended to wear protective gear, such as gloves or finger guards, when participating in sports or activities with a high risk of finger injuries. Proper technique and caution should also be exercised when handling balls or other objects that could strike the fingertips.

Non-Surgical Treatment

For less severe cases without fractures, the primary treatment is immobilization of the affected finger in an extended position using a splint or tape for several weeks to allow the tendon to heal. Immobilization of 8 weeks or more is common. Keeping the digit straight at all times is critical. It is just as important to move the other parts of the finger and hand. The splint must be just the right size and length.

Surgery

Surgery may be required for more severe cases involving fractures, joint misalignment, or significant tendon damage. The surgery may involve reattaching the tendon, fixing bone fragments, or fusing the joint.

Rehabilitation

After surgical treatment, physical therapy and rehabilitation exercises are crucial for regaining finger strength, mobility, and function. This may involve range-of-motion exercises, stretching, soft tissue massage, and strengthening exercises for the hand and finger muscles.

FAQ’s

Can mallet finger heal on its own?
While minor cases may heal with proper splinting, more severe injuries often require medical treatment or surgery to ensure proper healing and prevent long-term deformity or loss of function.

How long does it take for a mallet finger to heal?
The healing time can vary depending on the severity of the injury and the treatment method. Non-surgical cases may take 8 – 12 weeks of splinting, while surgical cases may require several months of rehabilitation.

Can you still move your finger with mallet finger?
While the fingertip cannot be actively extended due to the tendon injury, the rest of the finger may still have some mobility depending on the extent of the injury.

Is surgery always necessary for mallet finger?
No, surgery is not always necessary. Most cases can be treated successfully with splinting and immobilization, especially if there are no fractures or significant tendon damage. But it is critical to have the correct splinting and timing of the splint wear.

A lag in the extension compared to the other fingers is typical after treatment.

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