Mallet finger is a common tendon injury that occurs in everyday life, so termed due to the classic presentation of a finger deformity that resembles a “hammer” or ”mallet”.
What is a mallet finger?
How common is a mallet finger injury?
The prevalence of mallet finger is relatively high, accounting for 9.3% of all tendon and ligament lesions in the body. Injury trends indicate that it is more common among young to middle-aged men and occasionally in older women. 74% of mallet injuries occur in the dominant hand, and >90% of the injuries involve the middle, ring and/or little fingers.How does a mallet finger occur?
What are the signs and symptoms of mallet finger?
In the initial stages following the injury, you may experience pain, swelling and bruising over the end joint of your finger or thumb. The end joint of your finger stays in a bent position and there is an inability to straighten the joint on your own, unless helped by your other hand.How can mallet finger be treated?
It is important to seek early treatment for mallet finger as treatment success rates tend to decrease as more time passes by before the start of treatment. Non-surgical Treatment Options Most mallet finger cases can be treated successfully without surgery. Generally, the doctor will refer you to an occupational therapist, who will fabricate a customised splint for your finger. This splint will help to support your fingertip in a straight position so that the ends of the ruptured tendon are positioned close to each other, allowing for healing to take place. It is therefore of utmost importance that this splint is worn at all times for a period of at least 6 to 8 weeks. There should be no movement of the end joint of the finger during this period as bending of the joint during can lead to a re-rupture of the tendon.Surgical Treatment Options
Surgery may be needed for mallet injuries under the following circumstances:
– Bony mallet injuries where the bone fragment that broke off is of a larger size
– The presence of joint misalignment
– The tendon has been injured via a cut by a sharp object
– Previous non-surgical management by splinting has been unsuccessful
Surgical procedures may include the use of wires or small screws/metal plates to help realign the joint or re-attach the fracture fragment onto the original bone, as well as the repair or reconstruction of the cut tendon. Regular therapy sessions are usually required after surgery to help in regaining movement and strength of the injured finger/thumb.
Why is it important seek early treatment for mallet finger?
Without early treatment of a mallet finger, the extensor tendon will not be able to re-attach itself onto the bone and heal, leading to a permanent deformity of the finger. Over time, this may continue to worsen due to the imbalance in muscle tendon forces, resulting in a swan-neck deformity of the finger, where the middle joint becomes hyperextended in addition to the end joint being in a permanently bent position. Swan-neck deformities can cause difficulties in finger bending, as well as a snapping sensation during finger movements.
OT Joanna Lim is a senior hands specialist in the Lifeweavers team. She is passionate about ergonomics and rehabilitation of hand and fingers injuries, often writing specialised articles like this on her blog and contributes to the Lifeweavers Magazine.
Sources:
American Society for Surgery of the Hand. (2020). Mallet finger: Symptoms & Treatment: The hand society. Retrieved April 13, 2021, from https://www.assh.org/handcare/condition/mallet-finger
Physiopedia. (2021). Mallet finger. Retrieved April 13, 2021, from https://www.physio-pedia.com/Mallet_Finger
Salazar Botero, S., Hidalgo Diaz, J., Benaïda, A., Collon, S., Facca, S., & Liverneaux, P. (2016, March 18). Review of acute traumatic closed mallet finger injuries in adults. Retrieved April 13, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4807168/
Sheth, U. (2019). Mallet finger. Retrieved April 13, 2021, from https://www.orthobullets.com/hand/6014/mallet-finger
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