Mallet finger

 

MF Picture 1

How would this injury occur? 

A mallet finger occurs when the fingertip joint – the distal interphalangeal joint or DIPJ – is forcefully pushed into a bent position, for example, when hit on the end of the finger by a ball, or directly contacting an opponent.  This damages the attachment of the extensor tendon that straightens the finger.  This tendon sometimes pulls a piece of bone away with it, and this is known as a bony mallet.  

MF Picture 2

What are the signs and symptoms? 

Immediately after the injury the affected finger joint may be swollen and bruised, but not necessarily painful. 

The fingertip will droop into a bent position and it cannot straighten by itself. 

MF Picture 3

Why is treatment important? 

If left untreated, over time the fingertip/DIP joint may become stiff and this may cause changes to the middle joint - the proximal interphalangeal joint or PIP joint - of the finger. Without treatment, the DIPJ will never be able to fully straighten.  

When should you see an Accredited Hand Therapist? 

The sooner you see your local Accredited Hand Therapist (AHT), the sooner you will have the correct treatment, and the quicker your injury will heal. This injury is best treated as early as possible and you should not wait too long to start treatment.  

Your finger needs to be held straight at the DIP joint and the joint should not bend at all for 6-8 weeks. Your Accredited Hand Therapist will make a custom orthosis to keep the DIP joint straight and guide you through the immobilisation period, orthosis wean and exercises, when appropriate. You will then be back to the sport you love quicker and safely. 

MF Picture 5MF Picture 6

Should I get an x-ray? 

If you have had an x-ray, bring it to your first-hand therapy appointment. However, your AHT can send you for an x-ray and may refer you to a specialist doctor, if required. 

How long until I can play sport again? 

Your AHT will determine when you can safely return to sport, which may be early with an orthosis securely taped on if appropriate to your sport.  

You can find a Hand Therapist in your area by visiting the AHTA website home page and clicking on “Looking for an Accredited Hand Therapist?”.  All you will need is your postcode and you’re on the way to having your sports hand injury treated with excellent care. 

Brief story 1

  • Jane ‘didn’t feel a thing’ when she jammed her right ring finger into an opponent while playing OzTag. 
  • A teammate noticed the ring fingertip joint bent and knew that was not right! He taped the finger with a paddle pop stick for support and suggested Jane go to her local Hand Therapy. 
  • Jane was able to be seen the next day, was sent for an x-ray and was diagnosed with a tendinous mallet finger.  She was immediately fitted with a custom-made orthosis to support the right ring fingertip joint.  

MF Picture 8MF Picture 9

  • After 8 weeks of full-time orthosis use, Jane was allowed to start a limited number of light range of motion exercises, a few times per day to help her slowly regain her movement. 

MF Picture 10  

  • Over the next 4 weeks, Jane spent less and less time in her orthosis but wore it every night to sleep 
  • Although the tip joint was stiff (as expected) Jane will progress to having a very good recovery with full movement and power in the next couple of months, thanks to the treatment received from her Accredited Hand Therapist! 

Brief story 2 

  • Robert’s left little finger was struck by a cricket ball 3 weeks ago 
  • He saw his GP when the swelling wouldn’t settle and was sent for an x-ray.  

MF Picture 11MF Picture 12

  • Robert was diagnosed with a bony mallet finger. 
  • He was sent to his local Accredited Hand Therapist, and following assessment and x-ray examination, Robert was fitted with a custom-made orthosis to immobilise the left little fingertip (DIP) joint.  

MF Picture 9

  • His AHT taught Robert how to care for his finger while in the splint, which he will need to wear for a minimum of 6 weeks.