Mallet Finger

A mallet finger often referred to as a drop finger or baseball finger is an injury to the tendon that straightens the tip of a finger (or thumb). Tendons provide mobility and stability by connecting bones to muscles. When injured, the tendon may rip or separate from the finger bone. A child can occasionally hurt both their tendon and the bone in a finger. When a child has a mallet finger, he or she is unable to straighten the finger, it droops at the tip, is uncomfortable, and seems bruised or swollen. When a child tries to catch a hard ball and it strikes his or her extended fingertip in a sport like baseball, basketball, or football, a mallet finger injury may occur.

Causes

Any direct blow from a baseball (or football, basketball, or volleyball) to an outstretched finger can rip the extensor tendon that straightens the tip of one of your child’s fingers. Even less powerful direct impacts can have the same result. Children and teenagers will not be able to straighten their fingertips if they have impact damage to the extensor tendon. Tendons, which resemble ropes made of collagen (protein) fibers, link muscles, and bones. Only the soft tendon tissue may be torn in a finger impact injury. Alternatively, it could tear the tendon away from the fingertip bone.

On occasion, the tendon will separate from the bone with a piece of it. When young boys participate in sports, it is not unusual to see someone get a mallet finger. Children are more likely to get the injury from a direct shock, such as crushing a finger in a door, than adults. A strong blow to the tendon is the cause of most mallet finger injuries, but even a small amount of force can damage the tendon.

Mallet Finger Symptoms

Following the damage, the finger will hurt, and the tip will droop. The hand will be usable. 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.

Treatment

To immediately treat a mallet finger’s pain or discomfort and swelling:

• Use ice.
• Raise the hand so that the tips are in the air and over the chest.
• Utilize nonsteroidal anti-inflammatory medications (NSAIDs)

It’s a good idea to visit a doctor as soon as possible. Mallet finger injuries may frequently be treated 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.

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 be gradually improved. 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

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. Pain can be treated with over-the-counter anti-inflammatory medications if needed.

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, it is essential that the finger stays straight since any time spent bent may impede or delay recovery.

In some cases, doctors may schedule appointments over 6 to 8 weeks to monitor progress.  Although most people have normal finger function and appearance after splinting, in rare instances, some people cannot fully extend their fingers.

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.

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 be bent downward for a count of 10, then it should be straightened 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 be 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.

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.