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What is a mallet finger injury?

A mallet finger injury refers to a finger deformity that resembles a “hammer” or “mallet”. There are two types of mallet finger injuries:

  • A tendinous mallet finger injury which results from a tear of the extensor muscle tendon, which helps to straighten the finger, from its attachment site on the last bone of the finger.
  • A bony mallet finger injury, in which the force of impact causes a small fracture at the base of bone where the extensor tendon is attached to.

In both cases, the tendon is no longer attached to the last bone of the finger and is thus unable to pull the end joint into a straightened position, causing the fingertip to droop.

A mallet finger injury usually occurs with trauma or a forceful impact that results in the sudden forceful bending of the end joint of the finger (e.g. the hand is hit by a ball during sports, the finger is injured after a fall, stubbing of the finger against a hard surface while cleaning furniture). A crush injury over the fingertips (e.g. having a finger caught in a door) or a deep cut over the back of the fingertip can also result in detachment of the tendon.

How do I know if I have a mallet finger injury?

Signs and symptoms of a mallet finger injury may include:

  • Pain
  • Swelling and bruising over the end joint of the finger
  • Inability to straighten the last joint of the finger on your own, unless helped by your other hand

How is a mallet finger injury diagnosed?

Your specialist Doctor will obtain your health history and perform a physical examination. Your Doctor may also order radiological investigations (e.g. X-rays, CT scans) to help look for fractures and any joint misalignment.

How is a mallet finger injury treated?

It is important to seek early treatment for a mallet finger injury as success rates tend to decrease as more time passes by before the start of treatment. Mallet finger injuries can be treated both surgically and non-surgically, depending on the severity of the injury.

Non-surgical Treatment

Many cases of mallet finger injuries can be treated successfully without surgery. Your specialist Doctor may refer you to a Hand Therapist, who will fabricate a custom 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 close enough to each other for healing to occur. It is vital that the splint is worn at all times for at least 6 to 8 weeks, with the last finger joint immobilised completely during this period of time. Once your specialist Doctor ascertains that the extensor tendon and/or fracture are healing adequately, you will be able to see our Hand Therapist to start gentle finger exercises.

Surgical Treatment

Surgery may be needed for mallet finger injuries that are more complex, for example:

  • A bony mallet finger where the bone fragment that broke off is of a larger size.
  • The presence of joint misalignment.
  • Previous non-surgical management by splinting has been unsuccessful.

After surgery, our Hand Therapist will fabricate a customised splint to immobilise the end joint of your finger for around 6 weeks in order to protect the tendon repair and/or fracture while they heal. When the healing is complete, Hand Therapy will begin.

Hand Therapy

Joint stiffness, muscle tightness and loss of function of the finger and hand are common problems in the early stages of recovery from a mallet finger injury. As such, daily activities such as self-care (e.g. dressing, showering, brushing of teeth), work activities and leisure pursuits (e.g. baking, tennis, gym activities) are often affected. Hand therapy plays a pivotal role in the recovery of hand and finger movement, strength and function after a mallet finger injury. Most mallet finger injuries take around 3 to 4 months to heal before you are able to return to your normal daily activities, and full recovery from these injuries can take up to a year.

If you require protective immobilisation for your finger, your specialist Doctor may refer you to our Hand Therapist for a customised splint. Once you are able to start therapy for your finger and hand, our Hand Therapist can then help you in your recovery through treatment options such as:

  • Advice and education pertaining to your condition
  • Wax therapy
  • Ultrasound therapy
  • Exercises to improve finger joint and muscle movements
  • Management of swelling
  • Scar management
  • Strengthening exercises
  • Soft tissue mobilisation and release
  • Pain relief/management
  • Functional retraining of the finger and hand
  • Personalised home exercise program