Mallet Finger

Understanding Mallet Finger

Mallet finger, commonly known as “baseball finger,” is an injury to the extensor tendon at the fingertip. Resulting in the inability to straighten the finger. This condition often arises from trauma that forces the fingertip into excessive flexion. Leading to tendon damage. Prompt diagnosis and appropriate treatment are crucial to prevent long-term deformity and resulting functional impairment.

The Anatomy Of A Mallet Finger Injury

The hand’s extensor tendons are responsible for straightening the fingers. These tendons run along the back of the hand and attach to the distal phalanx—the fingertip bone. When excessive force is applied to the fingertip, such as during sports activities or accidents, it can overstretch or rupture the extensor tendon at its attachment point. In some cases, the force may also cause a small piece of bone to detach along with the tendon, known as an avulsion fracture.

Causes of Mallet Finger

Mallet finger is commonly associated with sports injuries, particularly in activities where rapid hand movements and fingertip impact are frequent. For example:

• Sports-related injuries: This injury is prevalent among baseball, cricket, basketball, and volleyball players. Athletes who often experience fingertip trauma while catching, or deflecting a ball.
• Everyday accidents: Simple tasks like closing a door, tucking in bedsheets, or handling heavy objects can result in accidental hyperflexion of the fingertip.
• Workplace injuries: Jobs that involve repetitive, or forceful use of the hands may increase the risk of tendon injuries, including mallet finger.

Symptoms

The primary symptom of mallet finger is the inability to straighten the fingertip. Other symptoms include:

• Pain and tenderness at the distal joint.
• Swelling and redness around the affected area.
• A noticeable droop at the fingertip joint.

If left untreated, mallet finger can lead to permanent stiffness, deformity, and diminished function, underscoring the importance of prompt medical evaluation.

Treatment Options

The treatment for mallet finger largely depends on the severity of the injury. The goal is to restore the ability to straighten the fingertip and prevent long-term complications.

Splinting

For most cases, splinting is the first line of treatment. A removable finger splint is typically used to hold the fingertip in an extended position, preventing the tendon from further damage and allowing it to heal in a shortened position. The splint must be worn continuously for 6-8 weeks to ensure proper recovery. It’s essential to follow medical guidance on how and when to remove the splint, as premature removal can compromise healing.

• According to the NHS, the splint should be worn for up to 8 weeks, only removing it to clean your finger and the splint. Keeping the finger tip “straight” whilst doing so (unless otherwise advised).
• The American Academy of Orthopaedic Surgeons recommends wearing the splint full-time for 6 to 8 weeks, including during bathing, to restore function to the finger.

Surgery

If the mallet finger involves a significant avulsion fracture or joint instability, surgical intervention may be necessary. Surgery often involves fixing the fracture with pins, wires, or screws or repairing the tendon itself.

Physiotherapy

After the splinting period, physiotherapy is often used to regain normal function. Exercises designed to improve strength, range of motion, and general hand function, reducing stiffness and prevent reinjury. A structured physiotherapy program can play a pivotal role in the recovery process. 

• Range of Motion Exercises: These exercises help restore flexibility in the affected finger and surrounding joints.
• Strengthening Exercises: Focused on improving grip strength, injured tendon strength and overall hand functionality.
• Joint Mobilization: Used to address stiffness and ensure smooth movement of the finger.

Preventing Mallet Finger

While not all injuries can be prevented, adopting protective measures can minimize your risk of mallet finger. These include wearing the appropriate gloves during high-risk activities like wicketkeeping, baseball, goal keeping.. Learning and using proper techniques in sports, as well as remaining cautious when handling heavy objects.

Mallet finger may seem like a minor injury, but it can have significant long-term consequences if left untreated. Using a removable finger splint, combined with physiotherapy and, in severe cases, surgical intervention, can help restore normal finger function. If you suspect mallet finger, it is best to seek medical attention promptly to ensure the best possible recovery. With proper care, most individuals will regain full use of their finger and avoid long-term complications like the visual finger tip deformity.