Treatment for Mallet Finger

This Needs Splinting to Prevent Problems

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A mallet finger, sometimes called "baseball finger" or drop finger, is caused by an injury to the tendon at the tip of the finger that causes the finger to be permanently bent. It's frequently caused by jamming your finger.

After the injury has occurred, you may notice that the tip of your finger "drops" and you are unable to fully straighten it. This may seem like a minor problem, but if it isn't treated properly, it can lead to long-term problems.

Causes of a Mallet Finger

A mallet finger is an injury to the extensor tendon on the back of the finger, which is the tendon used to straighten the digit.

The tendon has several attachments on the back of the finger, including one just beyond the last knuckle that allows this last finger joint to extend (straighten). When the tendon is injured, there is nothing to pull that last knuckle straight, and therefore, the joint stays bent.

Some of the common causes of a mallet finger include:

  • Sports injuries in which a ball hits the end of the finger (hence the name baseball finger)
  • Falls in which you to land on your extended finger

Less often, a minor force like tucking a bedsheet under the mattress can cause enough damage to result in mallet finger.

While "jamming" your finger is the most common cause, you can also get mallet finger from cuts, crushing injuries, or a deep abrasion.

Always take it seriously when an injury leads to your finger not looking normal or bending properly.

If you cannot fully straighten the finger, or if there is a deformity of the finger, that is a reason to have a jammed finger injury evaluated by a trained medical provider.

Symptoms of a Mallet Finger

A mallet finger is an obvious injury, if you know what you're looking for: the last joint of the finger will be bent down, and while you can push the tip up with your other hand, the finger won't fully straighten on its own.

When you first hurt your finger, it can be quite painful, but the pain tends to drop off fairly quickly. Most people with a mallet finger are tender at the site of the injury, just behind the base of the fingernail. Due to minimal pain, many mallet fingers go undiagnosed for weeks or longer, because people are unaware of the significance of their injury.

In some people, when the tip of the finger is struck quite forcefully, there may also be injury to the fingernail, and the underlying nail bed. Often there is bruising noted underneath the fingernail. Depending on the amount of blood that accumulates, this can lift up the fingernail, and in some situations, the fingernail may fall off, although this is unusual.

Diagnosing Mallet Finger

Diagnosing mallet finger is fairly simple, since it's a pretty obvious injury. Doctors will examine the finger and typically perform an X-ray to assess the finger joints and the bones.

Most mallet fingers cause damage only to the tendon, so the X-rays will look normal.

Treatment of a Mallet Finger

Most of the time, even if treatment is delayed, mallet fingers heal in about eight to twelve weeks with just a simple splint.

A Stack splint is the easiest type of splint to use for this injury. It is shaped like your fingertip and slips over your finger to below the level of the joint. You can find ones that are clear or are flesh-colored.

If you take the splint off and allow your finger to bend before it's healed, the treatment will probably have to be restarted from the beginning. Since a Stack splint is usually worn for four to eight weeks, this can be a significant challenge! If you do take off the splint for any reason (such as to clean it), make sure you don't allow your finger to bend.

With a splint in place and the fingertip kept straight, there should not be significant discomfort. While no one wants to be in pain, the lack of pain is often a problem, as it makes it easy to be less careful than you should be about proper treatment and splinting techniques.

When Surgery Is Necessary

Some situations may require surgical intervention.

Most mallet fingers are an injury to the tendon itself, but in some cases, the tendon may pull off a small fragment of bone from the finger bone. This is called bony mallet finger.

If the bone fragment is large enough, it may require surgical treatment to prevent joint problems from developing.

Surgery may also be needed in situations where the injury is left untreated for more than four to six weeks and problem called a swan-neck deformity develops.

Because the tendon that straightens out the tip of the finger is pulled back, more force is acting on the first knuckle of the finger. This abnormal force creates hyperextension of that knuckle and leads to deformity over time.

Sometimes, a swan-neck deformity is a cosmetic issue, leading to no significant functional problems. In other cases, though, it can impair your finger's normal function.

A Word From Verywell

A mallet finger is more than just a typical jammed finger. Without proper treatment, permanent deformity can be the result. Fortunately, most people can heal this injury with the proper use of a simple splint. Having this injury evaluated and properly treated is critical to the successful recovery from a mallet finger injury. Not having proper treatment can lead to permanent deformity.

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Article Sources

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  1. American Academy of Orthopaedic Surgeons, OrthoInfo. Mallet Finger (Baseball Finger). Updated March 2015.

  2. Bachoura A, Ferikes AJ, Lubahn JD. A review of mallet finger and jersey finger in the athlete. Curr Rev Musculoskelet Med. 2017;10(1):1-9. doi:10.1007/s12178-017-9395-6

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