What is mallet finger?
Mallet finger, known as drop finger or baseball finger, is an injury to the tendon that straightens the tip of your finger (or thumb). Tendons attach your bones to your muscles, providing stability and motion. With injury, the tendon can tear or detach from the finger bone. In some cases you may injure your finger bone along with your tendon. If you have mallet finger, you’re unable to straighten your finger, it droops at the tip, is painful and looks bruised and/or swollen.
Mallet finger is an injury that frequently occurs in sports such as baseball, basketball or football when you try to catch a hard ball and it hits your extended fingertip. The injury frequently affects a finger on the hand you use the most (your dominant hand).
How common is mallet finger?
Mallet finger is a common condition, especially with athletes. But it can also occur when performing household activities if you strike the tip of a finger on an immoveable object such as a door or wall.
Who is at risk of mallet finger?
This injury is most commonly in baseball players, but it anyone who plays a sport that involves hard balls (basketball, volleyball, football, etc.) can get it. In fact, anyone can get a mallet finger injury, even from doing something as simple as making the bed.
Symptoms and Causes
What causes mallet finger?
Mallet finger injury happens when something hard hits your extended finger or when there’s some trauma to your fingertip, like getting it caught in a door.
What are the symptoms of mallet finger?
After the pain of the initial injury you may experience:
- An inability to straighten your fingertip.
- A detached fingernail.
- Redness under the fingernail bed.
Is mallet finger a sign of arthritis?
No. Mallet finger is an injury and is unrelated to arthritis.
Can mallet finger cause arthritis?
When your injury involves only the extensor tendon, subsequent arthritis rarely develops. But you may develop arthritis if the tendon pulls off a piece of bone from the joint surface and it remains displaced.
Diagnosis and Tests
How is mallet finger diagnosed?
After realizing that you’re unable to straighten your finger, your healthcare provider may require an:
- On rare occasions, supplemental imaging studies such as an ultrasound or MRI may provide additional information.
Management and Treatment
Can mallet finger be fixed?
Both immediate and long-term treatment is essential to healing.
When you’re injured you should immediately:
- Wrap an ice pack in a towel and put it on your finger.
- Hold your finger above your heart. This can keep down the swelling and reduce the pain.
- Take over-the-counter pain medications, if needed.
Long-term treatment involves putting your fingertip into a splint and keeping it there for a minimum of six weeks while your tendon heals. If there is a piece of bone pulled off, your healthcare provider may order another X-ray after a week or two of splinting to check on the appropriate position of the bone fragment and the healing process. You’ll then wear your splint day and night for a minimum of six weeks. During this time, the splint may be carefully removed to allow for cleansing of both the splint and the finger, but you should avoid strenuous activities and sports to prevent recurrent injury.
There are several types of splints. Talk to your healthcare provider about the best type for you. You’ll need to wash and dry the splint once a day (keep your finger straight when you do it). You should also ice your splinted finger for 10-20 minutes three to four times per day.
If your mallet finger injury is more complex, your surgeon may need to surgically insert a small pin into your finger to hold the joint straight while it heals.
Which healthcare providers treat mallet finger?
Your primary healthcare provider may be able to treat your mallet finger. If needed, they’ll refer you to a hand physiotherapist or an orthopaedic surgeon.
Do I need surgery?
Surgery for mallet finger is rare. But if your joint is misaligned, your finger is broken or there are bone fragments that result in an unstable joint, your injury is considered “complex” and may need surgery. For this type of surgery, your surgeon may make a small incision in your skin or to insert a pin or wire to keep your fingertip straight.
Is the surgery for mallet finger inpatient or outpatient?
Surgery to repair a mallet finger is an outpatient procedure, usually performed under local or regional anesthesia (with sedation if needed). You’ll be able to go home once you’re stable and shouldn’t need to stay overnight in the hospital.
Who performs the surgery?
An orthopedic surgeon with experience in hand surgery performs mallet finger repair.
Will I have to exercise my finger?
After a minimum of six weeks and adequate healing, your hand physiotherapist may develop a stretch and exercise routine to help strengthen your finger. They’ll show the exercises so that you can do them at home.
What are the complications from the treatment of mallet finger?
Most complications result from lack of adequate treatment that doesn’t appropriately immobilize your finger. In rare cases, despite appropriate care, the tendon simply doesn’t heal. In these cases, solid destabilization surgery (fusion) of the end of two bones can provide healing and stability with essentially normal function.
How long does it take to recover from a mallet finger injury?
Even after eight to 12 weeks of splinting, it might be another three to four months before your mallet finger fully heals.
Can mallet finger be prevented?
You can do your best to avoid mallet finger injuries by being careful when you play sports that use a hard ball. But these injuries are common accidents that aren’t always preventable.
Outlook / Prognosis
What’s the outlook for people with mallet finger?
Most people recover from a mallet finger injury and regain full — or near-full — use of their finger without surgery.
Can mallet finger come back after it’s treated?
Mallet finger is an injury. Like all injuries, you can get mallet finger again after it heals.
What happens if mallet finger goes untreated?
If you don’t treat your mallet finger injury, your finger could become stiff and even unbendable. You may develop a problem where your finger has a swan’s neck shape.
If your young child has mallet finger and doesn’t get treatment, their finger may not grow properly.
Can I live a normal life with mallet finger?
Yes. A mallet finger is an injury that should be treated, but you should be able to go about your daily life. You’ll need to avoid sports until you’ve completely healed. You may need to take some time off work depending on how much you use the injured finger for your job.
When should I go to the emergency department?
You should go to the emergency department when you get injured. You’ll need to know if the tendon was torn, if it detached from the bone or if there’s a fracture.
A note from Cleveland Clinic
Mallet finger is a painful injury with a simple treatment. In most cases, you should be back to normal after three to four months. Contact your healthcare provider as soon as you’re hurt. Sometimes people assume the injury isn’t serious and hesitate to get checked out. This can delay the healing process and you might need to wear a splint for a longer period of time. Remember to take your pain medications as prescribed, wear your splint for a minimum of six weeks as instructed by your provider, and do your finger exercises. Stay in contact with your healthcare provider and let them know about any additional problems or concerns.
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