What is mallet finger?
Mallet finger is a common injury that occurs when the tendon on the top of the finger (the extensor tendon) tears or comes loose from the bone, usually as a result of a direct impact on the tip of the finger. This can happen when catching a ball or with another impact in which the finger is suddenly and forcefully pushed downwards. Because of this damage, the tip of the finger can no longer be straightened and stays in a bent position.
How does mallet finger develop?
Mallet finger is often caused by trauma in which the finger is suddenly bent while the extensor tendon is tensed. This can happen during sports such as basketball or volleyball, when a ball hits the outstretched finger and forces it downwards. The injury can also be caused by a cut or a sharp object that severs the tendon.
There are two forms of mallet finger:
- Soft tissue injury: Only the tendon is torn, without any bone being involved.
- Bony mallet: This is a more serious variant in which the tendon comes loose together with a piece of bone from the end of the finger bone.
What are the symptoms of mallet finger?
The symptoms of mallet finger are clearly noticeable immediately after the injury:
- Inability to straighten the tip of the finger: The most noticeable symptom is that the end of the finger stays in a bent position and can no longer be actively straightened.
- Pain and swelling: Pain and swelling can occur at the end of the finger immediately after the injury.
- Bruising: In some cases, bruising can occur due to a contusion or slight bleeding under the skin.
How is mallet finger treated?
The treatment of mallet finger depends on the severity of the injury, but usually consists of non-surgical or surgical options:
- Non-surgical treatment: The most common treatment is continuously wearing a splint that keeps the finger straight in an extended position. This splint usually has to be worn day and night for six to eight weeks, without bending the finger, to give the tendon a chance to heal. After this period, the splint can be worn at night only for a few more weeks.
- Surgical treatment: In some cases, such as a bony mallet involving a bone fragment, surgery may be needed to reattach the tendon and the bone. Surgery may also be needed if non-surgical treatment fails or if there is a complex fracture.
Recovery and rehabilitation
The recovery process can vary depending on the severity of the injury and the chosen treatment method. With successful non-surgical treatment, the function of the finger can fully recover after a few months. It is important to wear the splint correctly for the prescribed period, as bending the finger too early can lead to a poorly healed tendon and permanent stiffness or deformity.
After the splinting period, physiotherapy may be recommended to gradually restore the movement and strength of the finger. In some cases, a slight bend at the end of the finger may remain, even after full healing, but this usually has little effect on hand function.
What is the difference between mallet finger and other finger injuries?
Mallet finger is specifically characterised by the inability to straighten the tip of the finger, which distinguishes it from other finger injuries such as a finger fracture or tendinitis. While a finger fracture can lead to pain, swelling and a deformed finger, mallet finger involves specific damage to the extensor tendon, resulting in a characteristic bent finger.
Mallet finger is a common injury that can usually recover fully with the right treatment, provided the splint is worn consistently and the finger is well protected during the healing period.
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