Explanation: Mallet Finger occurs when there is a rupture of the terminal extensor tendon at the tip joint on the back of the finger. This injury consists of two types called bony or tendinous. Bony mallet means when the tendon ruptures it pulls off a small chip of bone with the tendon (called an avulsion fracture), whereas tendinous means only the tendon ruptures leaving the bone in tact. Both injuries result in the tip of the finger dropping or lagging and being unable to actively straighten. This injury is normally not painful but still essential to treat to prevent long-term functional implications.
Mechanism of injury: Direct forces on the tip of the finger primarily cause these injuries. This can include fingers hitting an object such as a ball or simple tasks such as making the bed.
Examination: When a mallet injury occurs it is important to consult your GP for an appropriate referral or contact a hand therapist and have an X-ray completed to identify the extent of injury.
Treatment: Commonly hand therapists manage mallet fingers through splinting to ensure appropriate joint alignment and healing. Skin integrity is also monitored while splinting. After an immobilisation splinting period identified and monitored by your hand therapist, increasing safe movement and strength will be addressed as appropriate. Alternatively, surgeons may surgically stabilise the tip joint of the finger (e.g. a wire, screw) if the size of the avulsion fracture is too large. Hand therapy is again essential in the instance of surgical stabilisation, to monitor for wound care and when appropriate increase strength and movement. Lastly, hand therapists monitor for and treat any secondary issues that can arise from a mallet injury, due to injuries to the adjacent ligaments of the finger that may also be impacted.