Mallet Finger is a deformity in which the fingertip bends downward at the end joint and can no longer be straightened. Occasionally it may associate a fracture of the base of the first phalanx.
Mallet Finger is sometimes called Baseball Finger as it a common fast ball injury. While routinely seen in athletes, this deformity can also occur from crush injuries, jammed fingers or even a knife wound. Whether the extensor tendon is cut or the bone is fractured at the site of tendon attachment the result is the same.
The mallet finger deformity will be evident at the time of injury. The distal phalanx will not straighten without physical assistance. Various degrees of pain, swelling, and tenderness will be present dependent on whether or not the bone is fractured.
Mallet Finger is easily diagnosed due to its unique presentation. X-rays will be ordered to assess for the presence and extent of bone fracture. This aids in determining the appropriate treatment plan.
Most cases of Mallet Finger can be treated without surgery, as long as there are no large bone fractures. A special finger splint may be applied to hold the digit in proper alignment while the tendon heals. The splint is worn continuously for 6 weeks, then at night for an additional 6 weeks.
Surgical repair may be considered when mallet finger injuries have large bone fragments or joint mal-alignment. In these cases wires or even small screws are used to secure the bone fragment and realign the joint or to do a temporary fusion of the distal interphalangeal joint.
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