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Mallet Finger

Date issued: December 2022

Review date: December 2024

Ref: A-543/NB/ED/Mallet finger ED version

PDF:  Mallet finger final December 2022.pdf [pdf] 165KB

What is a mallet finger?

The usual cause is an injury to the end of the finger. The injury tears the tendon that straightens (extends) the end of the finger. The same deformity can occur if the tendon pulls off the bone, usually causing a small fracture (break) in the bone. Without the use of this tendon the finger stays bent (flexed). It is often painless though in some patients it can be painful for up to 2 or 3 months.

How is it treated?

  • A plastic splint is worn for up to 12 weeks to keep the finger straight. By holding the finger straight, the ends of the tendon are brought together, helping the tendon to heal

  • In cases that are left for more than a week without treatment the chance of the tendon healing is much less

  • We will usually arrange to see you again after about 1-2 weeks to ensure that there are no problems, and we will then see you again 6-10 weeks after that for the splint to be removed. Plan to be in the splint for a total of 12 weeks, and for a period of “protected mobilisation” after that (usually another couple of weeks)

  • You may be referred to Occupational Therapy for a well-fitting splint at your initial review.

How should I look after the splint?

  • Ideally the splint would be put on in hospital and left there.  However, the finger will get dirty and smelly, and you will want to wash the finger and splint

  • If the end of the finger is allowed to bend during this time, healing will not occur and the droop of the finger will be permanent. The splint should therefore only be taken off for cleaning your finger while keeping the finger straight

  • Remove the splint KEEPING FINGER STRAIGHT ALL THE TIME. You can do this by holding your finger straight and pressed down e.g., on a table, sliding the splint off, washing and drying finger and sliding splint back on securing it with tape

  • We will show you how to tape your splint. When you tape the splint be sure not to do it so that the other joints are prevented from moving, or you may end up with a stiff finger.

What happens when the splint comes off?

  • Hopefully the tendon will have healed, and some exercises will help reduce any stiffness you may have.

  • In a proportion of cases, the tendon does not fully heal. However even if this happens, most patients are still able to use their hands normally.

  • A small number of patients may need an operation if they have problems with using the hand but unfortunately surgery will not restore full movement of the finger. If you have problems with using your hand, the doctor or practitioner will discuss the options with you.

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