If you find the tip of your finger is drooping down and you can’t straighten it, you may have a ‘mallet finger’ injury. A mallet injury is where you are unable to straighten the tip of your finger. A mallet injury does not appear significant however can lead to other complications or deformities if left untreated.
Mallet finger injuries are common in ball sports or when the finger hits an object. They can also occur from simple activities like making the bed or getting dressed.
Characterised by the appearance of a drooping fingertip, there are 2 types of mallet injury: a fracture or tendon rupture.
A fracture or “bony mallet” means the extensor tendon has pulled a small fragment of bone from where it attaches on the fingertip phalanx bone.
A “tendinous mallet” is where the extensor tendon has ruptured, both mean there is no connection of the muscle to the phalanx to extend or lift the fingertip.
It is important to determine which type of injury your finger has, as this will affect the treatment you received. Your therapist will make you a custom-made thermoplastic splint to wear on the top of your finger in a straight position for a number of weeks to let the fracture or ruptured tendon heal. Any bending of the fingertip will interrupt the healing and the measured number of weeks will need to start again.
The sooner your injured finger is placed in a splint the better the outcomes. Delaying the healing of the fracture and tendon can result in a “lag”. A lag refers to the lack of active finger extension or how much the finger is able to straighten, without needing help. A lag will occur when there is a delay in receiving treatment, as the finger will attempt to heal but due to re-injury there is the formation of scar tissue and swelling. This will impact the fragment of bone healing in the correct position or the length of the extensor tendon resulting in a lag.
If you have gone to hospital or seen a GP, they may put you in a “stack splint” these are pre-fabricated off the shelf splints that are not custom made to fit your finger. This is because they are an easy option in busy clinics that do not have splinting facilities. These stack splints do not achieve the best outcomes for mallet injuries however. For more information about stack splints please refer to our blog: 3 reasons why stack splints are not ideal for mallet injuries. If you have a stack splint on your finger right now, it is best to have it changed when you can to a custom made splint.
If left untreated a common complication that can result is a “swan neck deformity”. This is where the knuckle below the mallet injury, also known as the PIP joint, moves into hyperextension. If you notice this starts to occur, contact your hand therapist. It can be corrected by wearing a finger splint over the top of your mallet splint, and is often only needed at night depending on the severity.
At Health Nest, we custom make splints to suit your exact mallet injury and we guide you through a rehabilitation program. If you have a drooping finger, give us a call on 03 6338 1880.