Mallet Finger: Symptoms, Causes And Treatment

Thursday, May 9, 2019, 17:06

A mallet finger is commonly considered to be an athletic injury and is also termed as hammer finger. It occurs when the outermost joint of the finger gets injured. The injury makes it impossible to extend or move the fingertips without applying some kind of force. It affects the tendon, which is responsible for straightening the tip of your thumb or finger ^[1] .

A mallet finger can cause your finger to droop at the tip, look bruised and swollen and can be painful. You will not able to straighten your finger as the tendon would have become detached or torn from the finger bone. Mallet finger is a common injury and can affect any of the fingers,l though it mostly affects the dominant hand. Mallet finger is also known as baseball finger because the injury is commonly found in individuals playing baseball. It is commonly found in basketball players as well ^[2] .

Mallet finger takes around six to eight weeks to heal and may take more time, in some cases. There are chances that even after it is healed, you may not get the ability to straighten your fingers. The swelling, tenderness and redness will subside in a period of three to four months ^[3] .

Symptoms Of Mallet Finger

Once your finger gets injured, it will droop and will be painful in most cases. However, it does not prevent you from using your hands.

The common symptoms of a mallet finger are as follows ^[4] :

Swelling
Inability to straighten your fingertip
Bruising
Tenderness
Redness

Causes Of Mallet Finger

It is commonly reported in young individuals in sports activities. In children, it can be caused as a result of direct shock, like crushing a finger in a door.

It is not necessary that a mallet finger occurs only from a heavy impact, it can also develop as the result of a minor force which can injure the tendon. Injuries caused by low impacts are mostly viewed in older women while doing activities such as washing utensils or while making the bed ^[5] .

In sports, a direct hit to your extended fingers from a football, baseball, basketball etc. can cause the tendon to rupture ^[3] .

Diagnosis Of Mallet Finger

The doctor will b able to understand the condition by examining your fingertip. The drooping of fingertips will help the doctor carry out the diagnosis easily.

The doctor may ask you to take an X-ray and an MRI or ultrasound to examine and understand the extent of the injury. The x-ray will show the rupture of the tendon, bone fracture, and the alignment of the bones as well. The ultrasound and MRI are more sensitive in imaging the bone fragments ^[6] .

Treatments For Mallet Finger

In order to treat the pain and swelling of a mallet finger immediately, you can apply ice and keep your finger elevated, so that it is above your heart ^[7] , ^[8] , ^[9] .

Medications: Various over-the-counter and prescription pain relievers are available for dealing with the symptoms.
Splinting: It is the primary treatment method adopted for mallet finger. The affected finger will be kept straight in the splint until the tendon heals. You will be required to keep your finger in the splint for at least six weeks. After that period is over, you will be required to wear the splint only at night for another two weeks; and then for high-risk activities, such as manual work or sports.
Surgery: If the condition is severe and complex, the doctor will advise surgery. Surgery is required when the joint is not properly aligned and when the tendon requires a graft of tendon tissue from your body. Surgery will require the insertion of hardware (pin, wire, screw, plate) to keep the fingertip straight until the tendon is healed. In some cases, a suture may be required. Once the finger is healed, the suture will be removed.

Exercises For Mallet Finger

Once the surgery or the treatments are done, the doctor will give you an exercise to be followed, so as to keep the middle joint of the splinted finger from becoming stiff ^[10] .

Begin by holding your hand to support the middle joint.
Bend the joint slightly by keeping the splinted part of your finger straight.
Repeat it for ten times, for 4 to 5 times a day.

View Article References

[1] Garberman, S. F., Diao, E., & Peimer, C. A. (1994). Mallet finger: results of early versus delayed closed treatment.The Journal of hand surgery,19(5), 850-852.
[2] Stark, H. H., Boyes, J. H., & Wilson, J. N. (1962). Mallet finger.JBJS,44(6), 1061-1068.
[3] Bachoura, A., Ferikes, A. J., & Lubahn, J. D. (2017). A review of mallet finger and jersey finger injuries in the athlete.Current reviews in musculoskeletal medicine,10(1), 1-9.
[4] Botero, S. S., Diaz, J. J. H., Benaïda, A., Collon, S., Facca, S., & Liverneaux, P. A. (2016). Review of acute traumatic closed mallet finger injuries in adults.Archives of plastic surgery,43(2), 134.
[5] Davalos, S. A., Sosa, A. F., Gama-Herrera, J. A., & Ramirez, M. F. (2018). Association between initial Angulation and Outcome in Closed Mallet Finger Treated Conservatively.Plastic and Reconstructive Surgery–Global Open,6(8S), 220-221.
[6] Rosinsky, P., Sarig, O., David, Y., & Oron, A. (2018). MALLET FINGER-DIAGNOSIS, CLASSIFICATION AND TREATMENT.Harefuah,157(2), 104-107.
[7] Zhang, L., Zuo, Y. M., Huo, Y. X., Wang, G. Q., & Zhang, L. (2019). Scar overlapping suture for treating chronic tendinous mallet finger in children.Journal of orthopaedic surgery and research,14(1), 65.
[8] Walsh, C., Sills, M., & Markey, G. (2018). An 11-year-old with mallet finger.Emerg Med J,35(11), 679-680.
[9] Cressey, B. D., Clark, A., & Jellinek, N. J. (2019). Mallet Finger as a Complication of Dermatologic Surgery: Diagnosis, Treatment, and Prevention.Dermatologic Surgery.
[10] Ahmed, S., Girgis, E., Saad, A., Edwin, J., & Compson, J. (2017, November). RESTRUCTURING TREATMENT PATHWAY FOR MALLET FINGER INJURIES. InOrthopaedic Proceedings(Vol. 99, No. SUPP_17, pp. 12-12). The British Editorial Society of Bone & Joint Surgery.