Finger Hand Hand Therapy Mallet Finger

Advice from a Certified Hand Therapist: Mallet Finger

Mallet_Fig1A

What is happening to my fingertip? It doesn’t go straight anymore.

If you can’t extend the tip of your finger, you may have what is called a mallet finger. This happens when the end of the tendon that lifts your fingertip becomes separated from the fingertip. There are a few different ways this can happen.

Do I need to do anything about this? Will it heal on its own?

If you have a mallet finger, it needs to be treated; it will not heal on its own. You should consult with your doctor, and possibly a hand surgeon.

A hand surgeon? That sounds serious!

It may be. Sometimes the tendon comes off the fingertip with a portion of the bone – sometimes it only comes partially off. Having a specialist assess it and direct you will ensure you have a good outcome.

So I’m going to have to have surgery to fix this?

Probably not. Most of the time, a mallet finger can be fixed by using an orthosis (or splint) that holds it straight for a several weeks; however, sometimes it can be more serious, which is why it is a good idea to have it professionally evaluated.

That sounds like it might be easy. I guess I’ll make an appointment to see my doctor when I get around to it.

Wait a minute! You want to get that taken care of sooner rather than later. A mallet finger that is more than a few weeks old before treatment starts can be harder to fix, so get it looked at quickly!

You said they will put it in a splint. Does that mean I won’t be able to use my finger for several weeks?

Actually, depending on your individual needs, the orthosis will be pretty small. It only restricts motion at the joint at the end of the finger – not the other joints of the finger – so you will still be able to move your finger a lot. Some orthoses are designed to sit on the fingernail side of the finger, which can allow a little more sensation on the pad of the finger for activities like typing. Other designs wrap around your finger, and in some cases, an actual cast is made. Again, the design depends on your particular needs. You can find a certified hand therapist who can help guide you to the right choice.

You know… this droopy finger thing really doesn’t bother me that much, and it sounds like a lot of effort to take care of it. I think I’ll just take my chances and not seek treatment.

That is an option you have; however, you should be aware of some possible problems that may come back to cause you grief. While that little droop may not bother you, it is changing the way your finger works. The tendons of your fingers are put together like a well-balanced system of levers and pulleys.  When one pulley is not working correctly, it can impact the others. In the case of a mallet finger, this can result in a secondary deformity called a swan neck deformity. Just because you have a mallet finger does not mean you will develop a swan neck deformity – there are lots of factors at play – but it’s best to simply take care of the mallet finger.


Adam Holbrook, OTR/L, CHT is a certified hand therapist and a member of the American Society of Hand Therapists (ASHT).

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10 Comments
  • September 14, 2019 at 5:05 PM
    Reply

    I had a horse bite in aprail I lost the tip of finger and part nail bed the sergen made a new tip by creyatting a good this seems fine use splint at night and most of time I am trying to use it more by gragley doing light everyday things I started this about 3weeks ago and exercise that the therapist gave me but it went from 22percent up to 33percent I don’t know what it is doing I am trying to use it gradylley but how can I do this with out it getting warse any idea I not doing heavey work with it but I don’t want it to get warse but I have to use it any advise there was no damage to the bone or nerve

  • Kevin McCalmon
    July 11, 2019 at 4:37 PM
    Reply

    I have mallet finger and wore a splint for 3 months. Still wearing it at night and it is still sore, bent, and doesnt work right. What’s next?

    • Charlie White
      September 13, 2019 at 3:21 PM
      Reply

      I have identical problem. Wore splint 10 weeks, it did no good. Now they want to insert pin in finger.

    • Beth
      November 10, 2019 at 6:25 AM
      Reply

      Me too! I’m so sick of this splint !

  • Denise Hurst
    May 29, 2019 at 10:01 AM
    Reply

    I have a fracture ring finger put in splint April 8th and still swollen and i been getting therapy it still hurts. Do i have to have surgery its healing slow and i am 59 is thats why and its healing slowly

  • Evonne Sinclair
    May 6, 2019 at 8:26 PM
    Reply

    I have had a splint on for 3 months, for a mallet finger. It has been swollen and sore since April. I saw the doctor last week. He said keep using the splint, at night, and I have an appointment July 11. My finger still drops. How can I get rid of the soreness and stiffness? Thanks so much for your time.

    • September 14, 2019 at 5:12 PM
      Reply

      I think that I understand from my therapist said that when you are sleeping your hands go it strange poshion so it’s ment percent it from getting warse I use it most of time at the moment it’s gradually coming of maybe speack Tova hand therapist and see if you can get advce

  • Alex Kim
    March 24, 2019 at 4:24 AM
    Reply

    I have three deformed fingers from fist fights when young. Possible to treat these?

  • September 20, 2016 at 10:41 AM
    Reply

    […] tendons, ligaments and/or bones. Injuries to the tendons that straighten the finger are called mallet finger and central slip injuries. A jersey finger is an injury to the tendon that bends the […]

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