Understanding Mallet Finger: when your fingertip won’t straighten
It happens in a split second: a ball hits the tip of your finger, or you catch your hand while tucking in a bedsheet. Suddenly, the end of your finger is drooping, and no matter how hard you try, you can’t lift it back up. This common injury is known as a Mallet Finger.
What are Mallet Finger Injuries?
A mallet finger occurs when the extensor tendon responsible for straightening the tip of your finger is damaged. There are two main types:
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Tendinous Mallet: The tendon itself tears.
Bony Mallet: The force is so strong that the tendon pulls off a small piece of the bone where it attaches despite no tear in the tendon. This is known as an avulsion injury.
In both cases, the “bridge” that allows your muscles to pull the fingertip straight is broken.
This injury is almost always caused by a hyperflexion force—essentially, an object hitting the tip of a straight finger and forcing it to bend further than it’s meant to. While common in ball sports like cricket or baseball, it frequently happens during mundane household chores.
The “Droop”: The most obvious sign is the tip of the finger resting at a downward angle.
Inability to Straighten: You can push the finger straight with your other hand, but you can’t hold it there using its own strength.
Pain and Swelling: Especially around the outermost knuckle.
The golden rule for Mallet Finger is continuous splinting. To heal, the two ends of the tendon (or bone) must be kept in perfect contact. This usually requires wearing a specialised splint 24/7 for 6 to 8 weeks. Even removing it for a few seconds to wash your hands can “reset” the healing clock if the finger droops.
If left untreated, the imbalance of forces between your tendons in your finger can cause the middle knuckle to overextend while the fingertip remains bent, leading to a permanent “Swan Neck” deformity. This misalignment significantly disrupts the hand’s natural mechanics, making it difficult to perform basic tasks like gripping or buttoning a shirt.
Early intervention is the key to avoiding a permanent deformity and promote adequate healing. Our hand therapists can make you a custom splint, ensure your splint fits correctly, monitor your skin health and guide you through a safe strengthening program once the tissue has knitted back together.
Best of luck on your road to recovery!