Mallet Finger: Treatment Options

Mallet Finger: Treatment Options

This video will provide an overview of nonsurgical and surgical treatment options for mallet finger injuries. Mallet finger is a common injury to the fingertip. It results from an injury to the tendon on top of the finger, which helps extend or straighten the finger's tip. The injury can be of varying severities, from a simple disruption or tear of the tendon from the bone, to a traumatic cut to the tendon, or the tearing of the tendon with a small piece of bone attached, called an avulsion fracture.

Mallet finger injuries should be treated early after the injury to avoid complications such as chronic stiffness in the finger. If left untreated, another type of finger deformity called a swan neck deformity can occur, resulting from an imbalance of the injured tendon. Most mallet finger injuries can be treated without surgery. Anti-inflammatories may be given for pain, although these do not address the torn tendon. For this, an external finger splint will be used to keep the fingertip straight while the tendon heals. These must be worn full-time until the injury heals. This is typically 6 to 8 weeks.

Wearing the splint full time during this period is critical. Movement can jeopardize healing, which may require the treatment period to start over. Following the 6 to 8-week timeframe, the health care specialist will likely recommend another 2 weeks of part-time wear. Hand therapy will likely be advised to assist in regaining motion in the fingertip once healed.

Surgical treatment is generally advised for open injuries, meaning those with a skin laceration down to the torn tendon. Those that involve an avulsion fracture impacting a significant portion of the joint may also need surgery. If surgery is needed for a lacerated tendon, it will be repaired with a suture. Often, temporary wires are also used to hold the fingertip straight while the tendon heals. Wires may also be used if there is a fracture. If wires are used following surgery, they will remain in place for several weeks and eventually be removed in the office. A finger splint may be recommended for an additional period.

Hand therapy will be advised once the tendon is healed enough to work on range of motion. In summary, most mallet finger injuries can be treated without surgery. Treatment without surgery relies on full-time use of a finger splint for several weeks. Surgery will be considered for those involving an open laceration and cut of the tendon, and those with a significant avulsion fracture impacting the joint surface. Specialized hand therapy is often advised to help regain finger motion for treatment with and without surgery.