How Do You Fix a Mallet Finger?

Mallet finger is an injury that most commonly affects the middle, ring, or little finger after a forceful impact on the outstretched digit. A whopping 74% of cases impact the dominant hand. This injury is most often seen in middle-aged men, though anyone can experience mallet finger. It’s helpful to know what to look for with this injury so you can get proper treatment as quickly as possible. If you are experiencing mallet finger, book an appointment with The Hand and Wrist Institute.

What Is Mallet Finger?

man holding two white baseballs by Jose Francisco Morales is licensed with Unsplash License

Mallet finger, also known as baseball finger, is an injury that affects the extensor tendon on the back of the finger. This tendon is responsible for straightening the last joint on the finger, known as the interphalangeal joint. Mallet finger occurs when the tendon stretches, tears, or detaches and pulls a piece of the bone away with it. The latter injury is known as an avulsion fracture, and in this context, it’s referred to as a bony mallet.

Identifying Symptoms and Root Causes

Mallet finger typically occurs as the result of a traumatic injury to the finger. This injury is alternately known as baseball finger because it often happens when a ball hits the tip of the finger head-on. You can also get mallet finger from a fall, car accident, workplace injury, or from jamming your finger into something.

The most obvious symptom of mallet finger is the inability to straighten the finger. Other symptoms may include:

• Tenderness
• Bruising
• Swelling
• Redness

There is no singular pattern of pain with this injury. Some people experience sharp pain when the injury occurs, while others find that pain develops slowly over time. Still, other patients may have mallet fingers with no pain at all. If you can no longer manipulate the tip of your finger to extend fully, you likely have mallet finger and should seek medical attention to properly diagnose the problem.

Proper Diagnosis and Assessment

Have your health care provider diagnose mallet finger. They’ll begin with a physical assessment of the injury. If your doctor believes that you have mallet finger, they’ll typically order an X-ray to further assess the injury. This will conclusively determine whether you’ve suffered from a fracture and help determine your treatment plan.

Effective Treatment Options

Immediately following any hand injury, there are a few things you can do to treat your hand at home. For a mallet finger injury, it’s wise to remove any rings from the injured hand. This will keep them from getting stuck if swelling occurs. Elevating and icing the injured hand will help reduce swelling. You can make a temporary splint by gently taping your finger to a tongue depressor. Over-the-counter pain relievers can help manage pain if needed.

You should make an appointment to see a healthcare provider as soon as possible after your injury to develop a more comprehensive care plan.

Can Mallet Finger Be Fully Repaired?

A mallet finger can heal completely as long as appropriate action is taken. If you don’t immobilize the joint, it won’t heal properly. This can result in a permanently deformed finger. Over time, this deformity can even affect the other fingers due to the unequal use of the flexor and extensor tendons.

The sooner you seek medical attention, the faster and more effective your recovery will be. It’s important to follow your healthcare provider’s recommendations exactly for a full recovery.

Nonsurgical Mallet Finger Treatment: Splinting and Care

Most mallet finger injuries can be treated non-surgically. The most common approach is to splint the finger while the tendon heals.  You should wear the splint as directed, which typically includes 24-hour splinting for six to eight weeks after the injury, followed by an additional four to six weeks of splinting at night. Splinting options typically include:

• Stax splint: This lightweight finger splint covers the fingertip and is secured with tape.
• Figure-eight splint: This minimalist approach leaves the fingertip exposed and allows the second finger joint to flex while the first joint is immobilized.
• Aluminum and foam splint: As the name suggests, this splint is made of aluminum with softer foam cushioning on the underside. It’s taped into place and covers the entire finger.

If you have an aluminum or Stax splint, you’ll need to remove and clean the splint occasionally. Your doctor will show you how to take care of your splint and how to wear it properly for the duration of your healing time. Long-term use of a splint can irritate the skin, so your doctor may schedule follow-up appointments to evaluate your hand during the healing process or give you directions on how to examine your skin for problems.

When Is Surgery Necessary?

If the tendon is completely torn, the joint is dislocated, or you’ve suffered an avulsion fracture, you may need surgery for mallet finger. Surgery is uncommon for this injury because the tendons here are very thin and difficult to suture. It’s important to consult with a skilled hand specialist if you’re considering surgery for mallet finger.

Mallet finger surgery is an outpatient procedure. Your surgeon will use joint pins to secure the bones while your injury heals. If you’re suffering from chronic mallet finger or your injury was untreated for too long, your surgeon may fuse the joint. This will eliminate movement in the joint and permanently place it in a straightened position.

Recovery and Prevention Strategies

Once your splint is removed, your doctor will recommend finger exercises to regain motion in the joint. If you perform these exercises as directed, you should regain the proper range of motion. In some cases, the tip of the finger remains slightly bent, though it should function normally. Using protective hand equipment or stretching the fingers before and after exertion can help prevent mallet fingers.

Contact The Hand and Wrist Institute Today

If you’ve suffered a hand injury, get an expert consultation with our providers at The Hand and Wrist Institute in Dallas. We’re uniquely equipped to address injuries to this part of the body. Contact us today to make your appointment.

Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.