Mallet finger | |
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Other names | Hammer finger, [1] extensor tendon injury at the DIP joint, [2] baseball finger [3] |
Mallet finger of the middle finger. The tip of the finger bends downwards while the other fingers stay straight. | |
Specialty | Emergency medicine, sports medicine, plastic surgery |
Symptoms | Inability to extend the finger tip, pain and bruising of the finger [3] |
Causes | Trauma resulting in over bending of the finger tip [3] |
Diagnostic method | Based on symptoms, X-rays [3] |
Treatment | Splinting for 8 weeks, surgery [3] |
Prognosis | 6 to 10 weeks for healing [3] |
Frequency | Relatively common [2] |
A mallet finger, also known as hammer finger or PLF finger or Hannan finger, is an extensor tendon injury at the farthest away finger joint. [2] This results in the inability to extend the finger tip without pushing it. [3] There is generally pain and bruising at the back side of the farthest away finger joint. [3]
A mallet finger usually results from overbending of the finger tip. [3] Typically this occurs when a ball hits an outstretched finger and jams it. [3] This results in either a tear of the tendon or the tendon pulling off a bit of bone. [3] The diagnosis is generally based on symptoms and supported by X-rays. [3]
Treatment is generally with a splint that holds the fingertip straight continuously for 8 weeks. [3] The middle joint is allowed to move. [3] This should be begun within a week of the injury. [3] If the finger is bent during these weeks, healing may take longer. [3] If a large piece of bone has been torn off surgery may be recommended. [3] Without proper treatment a permanent deformity of the finger may occur. [2]
The diagnosis is generally based on symptoms and supported by X-rays. [3] The injury can be accompanied by swelling and ecchymosis. [4]
The management goal is to restore extension of the joint. [5] Treatment is generally with a splint that holds the first joint of the finger straight continuously for 8 weeks. [3] This should begin within a week of the injury. [3] The splint may be worn just at night for a few additional weeks after this. [3] The splint acts to immobilize flexing of the joint.
Surgery generally does not improve outcomes. [2] It may be required if the finger cannot be straightened by pushing on it or the break has pulled off more than 30% of the joint surface. [2] Surgery may be preferred over the use of a splint if a child is non-compliant. [5] If the problem has been present a long time surgery may also be required. [6] An open fracture may be another reason. Surgery will put the finger in a neutral position and drill a wire through the distal interphalangeal joint (DIP) to the proximal interphalangeal joint (PIP), forcing immobilization.