Mallet Finger

What is a mallet finger?

Mallet finger or ‘hammer finger’ is caused when the tendon that straightens the end joint of the finger suffers trauma and is torn. It is commonly caused during a sport where the end of the finger is caught but can also be caused by something minor like catching the finger when making the bed. The injury hits the tip of the finger or thumb and causes it to bend further than it is intended to go. This results in the finger or thumb not being able to be straightened on its own. It is a common injury and can affect any fingers in your hand, but usually affects the dominant hand.

In some cases, a piece of bone is pulled away with the tendon, this is called an avulsion fracture.

What are the symptoms?

Your finger may be painful after the injury. Signs that you may be suffering from mallet finger include:

Pain, swelling and bruising over the end of the finger
The end of the finger is in a noticeably bent position and will only straighten when pushed up with your other hand
The finger won’t straighten at the end joint

Your nail can also suffer injury and become detached from the nail bed. If this happens and there is blood underneath, it can be a sign of a cut or bone fracture and seeking medical advice quickly is recommended due to the risk of infection.

Treatment

Diagnosis of a mallet finger is possible by examining the dropped fingertip. You may need an x-ray, MRI, or ultrasound to establish the extent of the injury to the tendon and bone.

If a mallet finger is suspected, an x-ray is advised to rule out any fracture. The tendon can tear on the joint on the end bone of the finger, or a small fragment of bone can be pulled off which is called a mallet fracture.

To treat pain and swelling of a mallet finger, the following treatments can help ease symptoms:

Apply ice
Elevate your hand so that your fingers are above your heart
Take non-steroidal anti-inflammatory drugs (NSAIDS)

Mallet finger injuries can usually be treated successfully without surgery unless the injury becomes chronic.

If mallet finger is not treated, your finger can become stiff or for some people, the finger may develop a deformity, this is where the joint bends the wrong way.

Splinting

Splinting is the first line of treatment for mallet finger. The splint keeps the fingertip straight until the tendon heals. Keeping the finger in a splint is recommended for at least six weeks, followed by wearing it at night for a further two weeks. It is also advised to wear a splint during any manual work or sporting activities during those two weeks.

The splint still needs to be worn when bathing or showering. Care needs to be taken to keep the finger straight on a flat surface whilst you wash and dry the splint. If you bend the finger, it can stretch out the tendon and will have to repeat the healing process.

It is important to adhere to the splinting recovery pathway. If the joint flexes at all during the six weeks, the splinting process will have to be started again.

Surgery

Surgery is recommended for complex mallet finger injuries. This is where:

The joint is not properly aligned
The injury has a large bone fragment

Surgery may also be considered if wearing a splint is difficult or was previously unsuccessful. The surgeon may insert a wire into the finger to keep it straight, stitching the tendon together or making a new tendon, or fusing the joint so it stays straight.

Recovery

A mallet finger injury will take 6-8 weeks to heal properly, after which time you will be able to resume normal activities. Your surgeon may advise you to continue wearing the splint at night for an additional four weeks.

You should avoid any sporting activities that involve using your hands whilst your finger is healing and depending on your job you may need to take time off work to aid your recovery.

It can take 3-4 months for your finger to become fully functional again. It is normal to experience redness, swelling and tenderness for several months post injury, these symptoms will settle down eventually.

You may not be able to fully straighten the joint and there may be a small bump on the top of the joint, it may not be exactly as it was before the injury, but it should still function well once you have recovered.

Whatever your hand or wrist condition is, we can help.

Mr Randeep Mohil provides clinics across Lancashire and Cheshire.

Please call us on 01625 466158 or email info@northwesthandsurgeon.co.uk

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Lancashire Clinics

The Beardwood Hospital, Blackburn
Clinic days: Monday evenings (alternate) and Thursday mornings
Website: The Beardwood Hospital
Ramsay Fulwood Hospital, Preston
Clinic days: Monday and Tuesday evenings (alternate)
Website: Ramsay Fulwood Hall

Ramsay Euxton Hall Hospital, Chorley Clinic days: Tuesday evenings (alternate) Website:Ramsay Euxton Hall

Cheshire Clinic, Northwich Clinic days: Friday morning (alternate) Website: The Cheshire Clinic

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Mallet Finger

What is a mallet finger?

What are the symptoms?

Treatment

Splinting

Surgery

Recovery

Whatever your hand or wrist condition is, we can help.

Get in touch