QUESTIONS AND ANSWERS

Mallet Finger Symptoms

Following the damage, the finger will hurt, and the tip will droop. The child will not use his or her hand. A bone fracture frequently causes pain. Mallet finger signs and symptoms include:

• redness
• swelling
• bruising
• tenderness
• The need for the other hand to support the fingertip in order to straighten it

The fingernail can indicate a cut or a bone fracture if it is also broken, separated from the nail bed, or has blood under it. As soon as parents can, they should seek medical attention for their child since there is a chance of infection.

Mallet Finger Treatment

It’s a good idea to visit a doctor as soon as possible. Mallet Finger Doctors will normally treat a Mallet finger non-surgically unless the damage is severe. It’s essential to obtain treatment as soon as possible, even if your child does not feel any pain and his or her hand still functions. The finger may stiffen if treatment is not sought. Or the finger may develop a swan neck deformity, in which the joint bends in an incorrect direction. In addition, the injury may affect the finger’s articular cartilage, which controls bone growth. If it is not fixed, the child’s finger may grow incorrectly or with stunted growth.To immediately treat a mallet finger’s pain or discomfort and swelling:

Watch for Serious Signs

• It is very important to seek immediate attention if there is blood beneath the nail or if the nail is detached. This may identify a sign of a cut in the nail bed, or that the finger bone is broken and the wound penetrates (extends) down to the bone (open fracture). These types of injuries put you at risk for infection, so prompt medical evaluation becomes even more critical.

Which Fingers Are Most Commonly Affected?

Mallet finger most frequently affects the long finger, ring finger, and pinky of the dominant hand. Still, it’s important to note that any finger—even the thumb—can incur an injury in this way, depending on how the impact occurs.

Mallet Finger Physical Therapy Treatment

It’s typical to wear a splint continuously for 6 to 8 weeks. Then, with the use of exercises, the fingertip’s mobility can gradually improve. At this point, parents can reduce the amount of time their child wears the splint. Following immobilization, the finger normally requires 3–4 weeks to restore its full range of motion and strength.

Nonsurgical Treatment

The majority of mallet finger wounds don’t require surgery to heal. Mallet finger is a serious injury that requires medical attention since, if ignored, it can cause the finger to become permanently stiff or deformed. Mallet finger can produce cartilage problems that, if addressed, might inhibit bone growth in the finger, making it especially crucial for kids. After the incident, try to keep the finger raised over your child’s heart and apply an ice pack to minimize swelling. Remove any rings from the wounded finger since they can become difficult to take off later or they might even stop the blood flow. Doctors can recommend over-the-counter anti-inflammatory medications if needed for discomfort or pain.

Parents should keep applying an ice pack as required to reduce swelling and discomfort. Mallet finger treatment typically involves splinting the finger for 6 to 8 weeks, with the first 3 to 4 weeks of wear being continuous. Cleaning the splint and the skin below it once each day is required. For the first 3-4 weeks, the splint should be worn all the time, even when bathing. Splints are removed only once a day to disinfect fingers and splints. When removing the splint to clean the finger, the finger must stay straight since any time spent bent may impede or delay recovery.

Because wearing a splint for a long period can sometimes irritate the skin, your doctor may talk with you about how to carefully check for redness, sores, or other problems. Regularly inspecting the skin beneath the splint helps catch any issues early. In some cases, doctors may schedule appointments over 6 to 8 weeks to monitor progress and make sure healing is on track. These check-ins are also a good time to address any concerns or difficulties with the splint.

Mallet Finger Healing

After the initial continuous splinting period, your child will gradually wear the splint less frequently—often just at night—for another 3 to 4 weeks. Splinting treatment usually results in both acceptable function and appearance; however, most people have normal finger function and appearance after splinting, in rare instances, some people cannot fully extend their fingers.

For some children, following the splinting regimen can be quite challenging. If the splint cannot be worn as needed or if the joint is especially unstable, surgery may be necessary.  One procedure is to insert a temporary pin across the fingertip joint to hold it straight during the healing period. This pin is typically left in place for about 8 weeks and removed once the tendon has healed.

With careful splinting and follow-up, most children regain excellent finger use, though patience and attention to detail are key to a full recovery.

Mallet Finger Surgery

If none of the aforementioned remedies work, surgery is required to heal the torn tendon. Although the majority of incidents that result in a mallet finger do not cut the skin, surgery may be recommended if the finger is severely injured. It may be necessary to operate on a finger with major fractures or joint damage. To fix any fractures and encourage bone regrowth, the surgeon will employ minuscule pins, wires, or screws. Depending on the degree of injury, the tendon may need stitches or grafts for healing. Depending on the severity of the injury, the tendon may require grafts or sutures for healing.

Mallet Finger Exercises

To prevent the middle joint of the splinted finger from stiffening up, our doctor may recommend the following:

• Support the middle joint on either side with the other hand.
• Keep the finger’s splinted portion straight when bending that joint.
• Do this 4 to 5 times each day, 10 times total.

Our doctors may recommend additional exercises to help restore mobility to the damaged joint once the splint is removed. One is referred to as a blocking exercise:

• Put the other hand to work by pressing (blocking) the damaged finger’s middle joint.
• Just the last joint should bend downward for a count of 10, then it should bend straight for a further 10 counts.
• Perform this for 5 minutes, two to three times each day. This will strengthen the tendon and assist in regaining flexion.

Mallet Finger Recovery

Mallet finger recovery typically takes eight weeks. If the child does not follow the recommended splinting regimen, it can take longer. Most children recover quickly. It’s possible that at first, your child won’t be able to straighten the finger’s tip completely. The finger may appear sore, red, and swollen. However, these issues often go away within three to four months. The affected joint may occasionally have a little bump on top, but it is rarely uncomfortable and has no effect on how well the finger works.

The entire restoration of the finger’s functionality might take many months. For the first several months following the accident, any redness, swelling, or pain in the skin above the end of the finger may last. Eventually, these symptoms will normally subside.

What if my child’s mallet finger injury is old or isn’t healing?

If a mallet finger injury goes untreated for several months or longer, it becomes what doctors call a chronic mallet finger. In these cases, the finger may not respond to the usual treatments like splinting or therapy. Sometimes, the joint at the tip of the finger remains bent and can’t be straightened.

For children with a chronic mallet finger, orthopedic specialists might recommend a surgical procedure called joint fusion. This procedure permanently straightens the last joint of the finger, locking it in a position that works well for daily activities. While it means the fingertip won’t move anymore, it helps the finger look and function better—making it easier for kids to grip, write, and play without pain or awkwardness.

Treatment decisions are always tailored to each child’s age, activity level, and needs. Our team works closely with families to find the best solution, aiming for the safest route to a comfortable and useful result.

The Bottom Line

Mallet finger occurs when the tendon in the fingertip is damaged by an impact. Surgery is not always necessary to properly treat injuries. It’s advisable to consult one of our doctors as soon as possible for treatment if your child hurts a finger and can’t straighten the fingertip. The most crucial thing is to follow the doctor’s splinting regimen for the entire period of time.

Request An Appointment 

The Medical City Children’s Orthopedics and Spine Specialists has been providing excellent care for children for many years. We focus on improving the long-term health of your child’s bones. If your child is in pain as a result of a mallet finger, call one of our compassionate experts at 214-556-0590 to schedule an appointment with us. Finally, we offer personalized treatment and urgent pediatric care services at all of our four locations — Dallas, Arlington, Flower Mound, Frisco, and McKinney, TX.  If you notice any symptoms of a mallet finger in your child, don’t hesitate to contact us to avoid complications.

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Footnote:

American Academy of Orthopaedic Surgeons: Mallet Finger