The aim of treating a mallet finger deformity is to rebuild the extensor tendon insertion and restore extensor tendon length to achieve balance of distal interphalangeal joint flexion. Although it is also known as baseball finger, this injury can happen. Mallet thumb is a rarely seen injury, with limited reports on whether conservative or surgical treatment should be applied. The hand with the injured finger should also be elevated. Mallet finger is a common injury of the extensor tendon insertion. Mallet finger is a common athletic injury that affects basketball and baseball players routinely jammed fingers, but the injury can occur because of a crushing accident on the job, or even because of a cut finger while working in the kitchen. Mallet finger is a common injury involving either an extensor tendon rupture at its insertion or an avulsion fracture involving the insertion of the terminal extensor tendon. Two patients had sharply cut the extensor tendon on the dorsum of the proximal phalanx and two had avulsion of the extensor tendon from the base of the distal phalanx. Around twothirds of mallet finger injuries occur in the dominant hand. This video illustrates mallet finger nonsplint treatment with an exercise technique developed by valdas macionis, md, phd. It is caused by traumatic rupture of extensor tendon at its insertion in the base of the distal phalanx. Discussion mallet finger usually results from forced flexion of an extended finger. The tendon in the tip of your finger allows your fingertip to bend and straighten. With your index finger, slowly push the tip of your problem finger up.
Mallet finger why is physical therapy important to your recovery. Active pip flexion of affected finger with adjacent finger s held in extension. After 8 weeks of continuous splint wear, and keeping the tip joint of the finger straight 24 hour a day protecting it in a straight position when cleaning the finger as well, you are ready to start the 2nd phase of. Tendinous mallet finger, modified internal suture, anatomical fixation, treatment modality introduction mallet finger is a flexion deformity of the distal interphalangeal dip joint that results from dis ruption of the extensor tendon 1. However, the optimal treatment of each type of mallet finger injury. The conservative treatment of mallet finger with a simple splint. At six months the mean extension lag was 7 degrees and. Also known as baseball finger, it is an injury that is typically sustained while playing sports. Complications and prognosis of treatment of mallet finger. The result is that the tip of the finger droops into a flexed bent position due to the absence of an effective extensor tendon.
The finger usually regains acceptable function and appearance with this treatment plan. Otherwise, one of the other options may be perfect to keep your finger. The injury usually happens when the tendon is torn or stretched. Mar 01, 2006 injury to the extensor tendon at the dip joint, also known as mallet finger, is the most common closed tendon injury of the finger. Although it is also known as baseball finger, this injury can happen to anyone when an unyielding object like a ball strikes the tip of a finger or thumb and forces it to bend further than it. The technique is based on frequent holdrelax tipto. Mallet finger is a flexion deformity of the finger resulting from injury to the extensor mechanism at the base of the distal phalanx. Mallet finger injury no splint treatment by hand exercises. This program is most beneficial for those that have not had any surgery and they are conservatively treating their mallet finger with a splint only, followed with progressive exercises. This results in the inability to extend the finger tip without pushing it. Doctor answers on symptoms, diagnosis, treatment, and more. The single article published exclusively hand surgery service, maimonides medical center and center, state university of new york, brookn. It also tells you what you should and should not do.
If your tendon is torn or pulled off the bone, it should heal in 6 to 8. Treatment options for mallet finger vary depending on the length of time after injury that the droopy finger shows up its not always immediate. This will help avoid swelling and problems with the blood supply to the finger. Learning to cope with mallet finger the pathless wood. If surgery is necessary to repair the mallet finger.
If your tendon is only stretched, not torn, it should heal in 4 to 6 weeks if you wear a splint all the time. This article describes a treatment of tendinous mallet finger deformities using a modified internal suture technique for the stable fixation of the terminal extensor tendon and bone. Wrap the finger with a coban or coflex wrap while out of the splint gently flex the joint several times while the splint is off. You will not be able to straighten the end of your finger because the tendon connecting the muscle to the finger bone is stretched or torn. This injury, which typically results from trauma, such as when the fingertip is hit by a ball, causes the tip of your finger to droop. Wearing a splint on your finger to keep it straight is the most common treatment for mallet finger. The first step in treating a mallet finger is to apply ice to the finger immediately after injury and continue for about 15 minutes every two hours for the first few days. Conservative treatment consists of splinting the tip of the finger dip joint. Mallet finger causes, symptoms and treatment the hand society. The treatment of mallet thumb is discussed in the literature and includes conservative and surgical treatment 1,2,3,4,5,6,7.
A mallet finger is where the end joint of the finger bends towards the palm. Although it is also known as baseball finger, this injury can happen to anyone when an unyielding object like a ball strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. Feb 25, 2014 however, the optimal treatment of each type of mallet finger injury remains controversial. Swanneck deformities must be carefully examined to determine if the deformity is secondary to a chronic mallet finger injury or secondary to a pip joint volar plate injury or both. There is generally pain and bruising at the back side of the farthest away finger joint. The usual cause is an injury to the end of the finger.
Mallet finger is a flexion deformity resulting from avulsion of the extensor. Mallet finger is where the tendon that straightens the end joint of your finger has been torn. If youre suffering from finger or hand pain, a splint or brace might be the answer your looking for. Regardless of the treatment option, common sequelae include a slight extensor lag and a prominent bump on the dorsum of the finger. The diagnosis and management of mallet finger injuries ncbi. For uncomplicated mallet finger treatment involves splinting of the dip distal interphalangeal joint in slight hyperextension for a period of upto 8 weeks, with regular monitoring. Mallet finger treatment splinting is the treatment of choice for almost all mallet finger injuries. The general protocol for conservative treatment of a mallet finger is to splint the tip of the finger straight for approximately 68 weeks and then start to move it as long as it is stiff and does not droop.
Extension block pinning for large mallet fractures mayo clinic. Then wrap the finger with clean gauze or a clean cloth. A mallet finger is a deformity of the finger caused when the tendon that. The result of a mallet finger after injury is pain and swelling at the tip of the finger. In the 84 digits splinted there was a 45% rate of complications, mostly skin related. When a ball or other object strikes the tip of the finger or thumb and forcibly bends it, the force tears the tendon that straightens the finger see figure 1a and 1b. Mallet finger rehabilitation protocol conservative management kelly holtkamp, m. Treatment can be difficult as patient compliance is essential, and if not treated appropriately the injury can lead to permanent deformity.
The treatment of the mallet finger ranges from nonoperative with prolonged. A modified internal suture technique for treatment of the tendinous. They will determine bone involvement and whether the injury can be treated conservatively, or if it may require surgical intervention. Mallet finger is an injury to the end of your finger that causes it to bend inwards towards your palm. It can occur in a number of ways, but most commonly when a straight finger is stubbed and forced to bend suddenly at the joint near the tip.
Perform pin site care instruction if there are kwires outside of the skin. This document is to help you understand your injury, and reinforce the treatment required to get the best results possible. When it is injured, you cant straighten the fingertip anymore. Mallet finger most often happens when there is an injury to the tendon on the top side of your finger. Priority should always be given to conservative management of. A mallet finger is where the end of a finger is bent flexed towards the palm and cannot straighten. The index pointing finger of your good hand should be underneath the tip of the problem finger.
Mallet finger on demand focuses on recovery from week 0 week 12. Treatment you have been given a splint to keep the joint straight while you are using your hand. A doctor must carefully evaluate and treat this type of injury, so the finger does. Racgp mallet finger management and patient compliance. Between march 2011 and july 20, 15 patients with mallet fingers who had been treated using this modification were included in this study. Basketball and baseball players routinely experience jammed fingers, but the injury can occur because of a crushing accident on the job or even because of a cut finger while working in the kitchen. Rehabilitation following mallet finger south tees hospitals nhs. The extension block technique for the treatment of mallet. Objective this article discusses the current clinical assessment and appropriate management of mallet finger injuries. Place your thumb just below the joint that is closest to your fingernail. Feb 24, 2020 moreover, late osteoarthritis at the dip joint of an untreated mallet finger or a mallet finger that is treated without anatomic reduction of the fracture is rare, if not nonexistent. Rehabilitation following mallet south tees hospitals nhs.
Oct 01, 2010 orthopedics abstract this article describes the treatment of a bony mallet finger deformity using 2 extensionblock kirschner wires kwires with a transarticular kwire fixation technique for. The mallet finger splint is a simple splint and effective way to treat this injury. Mallet finger rehabilitation protocol conservative management. Original article a modified internal suture technique for. The results of a six to eightweek conservative course of treatment with a dipj splint in slight hyperextension for tendon lesions or straight for. The molded polythene splint for mallet finger deformities. Mallet finger selfcare at home if the finger is cut, clean the cut under running water for a few minutes.
Modification of the internal suture technique for mallet. Review of acute traumatic closed mallet finger injuries in adults. A mallet finger is a deformity of the finger caused when the tendon that straightens your finger the extensor tendon is damaged. Mallet finger usually results from forced flexion of an extended finger. Thus, the risk of poor outcome from illadvised open treatment far outweighs any risk of early dysfunction or late arthritis from splint treatment. This is usually caused by an injury to the end of the finger which has torn the tendon that straightens the finger.
Mallet finger is an injury to the tip of the finger when something hard, like a baseball, jams it. Fix your mallet finger with this simple, step by step self treatment program. Soft tissue mallet finger injuries with delayed treatment. Our telemedicine options include virtual video visits, telephone checkins, and patient portal communication. Do, keep your hand elevated if there is swelling and exercise all the joints except the splinted joint. Mallet finger involves loss of continuity of the extensor tendon over the distal interphalangeal joint. Mallet finger occurs when the tendon that straightens the last joint of your finger is torn. Patient information mallet finger what is mallet finger. A mallet finger refers to an injury whereby the extensor tendon to the tip joint distal interphalangeal of the finger is disrupted or torn. For complicated mallet finger injuries operative treatment has also been recommended. The purpose of this splint is to not allow the tip of your finger to bend at all. Open treatment can result in frequent complications, and the surgeon should resist the temptation to make good better by operating on these injuries.
Patients will present with a flexion deformity of, and inability to actively extend, the distal interphalangeal joint. Pdf mallet finger is a common injury involving either an extensor tendon rupture at its insertion or an avulsion fracture involving the insertion of. Mallet finger in children childrens hospital colorado. Original article treatment of mallet finger deformity with. Apr 25, 2016 should you or a teammate experience this, seek treatment from your local physician. A mallet finger is where the end joint of the finger bends towards the palm and cannot be straightened. The first type is called a bony mallet deformity which involves a fracture of the bone. Commonly an athletic injury, mallet finger occurs when the outermost joint of the finger is injured. Wear any rings on this hand until the injured finger has healed. In addition, a removable splint is fashioned for the a. Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb. Mallet finger why is physical therapy important to your. Get a printable copy pdf file of the complete article 561k. Rehabilitation following mallet finger patient information what is mallet finger.
Mallet finger is a flexion deformity of the distal. The conservative treatment of mallet finger with a simple. You may break the 1 hour time into several periods e. This technique catches the dorsal frag ment with a. Mallet finger patient information leaflet what is a mallet finger. Treatment can be difficult as patient compliance is essential, and if not treated. Treatment for mallet finger, a splint may be applied to keep your finger straight. A maitra and b dorani accident and emergency department, royal victoria infirmary, newcastle upon tyne. Mallet finger splint care instructions in order to achieve the best result, you must wear your splint 24 hours a day without interruption. At present, there are several treatment methods for mallet finger deformity, but the effects are different. There is no agreement on the indications for the surgical treatment of soft tissue mallet finger injuries. This means that your fingertip now droops and you cannot straighten it properly. Four cases of mallet thumb were treated conservatively by splinting the interphalangeal joint of the thumb in extension using the stack splint.
Treatment is deemed successful if there is little or no extensor tendon lag, meaning you are able to straighten your finger fully. The splint keeps the finger straight so the tendon can heal. Mallet finger on demand provides treatment for mallet finger. The whole reason i wrote this is because when i got my mallet finger i couldnt find very many blogs with personal experiences, and the ones i did find didnt have any practical advice. There are finger exercises that a hand therapist can teach you to strengthen your fingers, but you should be evaluated by a hand surgeon to make sue there are no correctable injuries. Mallet finger the complete injury guide vive health. However, any action that bends the joint further than it is meant to bend can cause mallet finger. Modified extensionblock kwire fixation technique for the. It will take a further six weeks before you can return to heavy activities. Learn everything you need to know about mallet finger causes, symptoms, and treatment options here. Surgical treatment surgical repair may be considered when mallet finger injuries have large bone fragments or joint malalignment. Mallet finger aftercare multimedia encyclopedia health. This can damage the tendon and bone, causing the finger to droop. A mallet finger, also known as hammer finger, is an extensor tendon injury at the farthest away finger joint.
Oct 25, 2014 mallet thumb unlike mallet finger, avulsion of the extensor pollicis longus epl tendon at its distal insertion mallet thumb is rare. The most conservative treatment option is long term splinting. Mallet finger typically occurs with jamming your finger, like hitting a basketball with a straight finger, forcing it to bend when not expected. Mallet finger most often occurs when something hits the tip of your straightened finger and bends it down with force. Splint weaning program for mallet finger deformity after you have worn the mallet splint all the time for the recommended period, usually eight 8 weeks or longer, depending on what you were instructed, you should follow the weaning schedule below. Mallet finger home program phase 2 exercises david gesensway, md notes. The tendon on the back of the joint snaps or pulls off its attachment to the bone. So i thought i would make my own experience available to anyone searching for tips on coping with mallet finger. The extension block technique for the treatment of mallet finger fracture. Exercises improve movement and strength of your finger after this injury. In children, mallet finger injuries may involve the cartilage that controls bone growth. The doctor must carefully evaluate and treat this injury in children so that the finger does not become stunted or deformed. This should be worn at all times even when sleeping for 8 weeks, then at night time only for an additional 8 weeks.
It is usually caused by a forceful blow to the tip of the finger causing sudden flexion or a hyperextension injury. Although robb 1 wrote in 1959 about the treatment of mallet fingers. Mar 29, 2019 mallet finger is a condition in which the tendon in the outermost joint of a finger is ripped, causing the tip of the finger to droop. Mar 11, 2017 the fish hook technique for bony mallet finger healio this study describes a new technique called the fish hook technique for the treatment of bony mallet finger. Mallet finger recovery exercises answers on healthtap. Most mallet fingers are treated by wearing a splint on the finger for up to eight weeks. The treatment options for the softtissue mallet finger, both acute and chronic, continue to generate a certain degree of controversy. Splinting is the most common initial treatment method for soft tissue or bony mallet finger. When a ball or other object strikes the tip of the finger or thumb and forcibly bends it, the force tears the tendon that straightens the finger. Mallet finger causes, symptoms and treatment the hand. This leaflet sets out some exercises you should do each day to help your finger to heal. If the tendon that attaches near the base of your fingernail is unable to withstand this sudden force, it avulses or rips off of the bone creating a droopy fingertip. It is important that your gp or treating clinician ensures your splint fits. Although the recommended treatment for closed mallet finger is conservative, some authors proposed operative treatment for mallet thumb.
Mallet finger advice on removal of your splint your tendon is becoming stronger but it is not fully healed. This common hand injury results in a flexion deformity of the distal finger joint and may lead to an imbalance between flexion and extension forces more proximally in the digit. An xray or mri may be used to determine if the tendon is torn if there is an avulsion or a fracture to the end bone of the finger if there is no avulsion or fracture, then a mallet finger. Summit medical group is making it easier than ever for patients to seek care while limiting exposure to covid19.