MALLET FINGER INJURY
 
Mallet Finger Injury
What is it?
A Mallet finger injury occurs when the tendon responsible for straightening the tip of the finger tears away from the bone. Without the tendon to hold the end joint straight (Distal Interphalangeal Joint, DIP) the joint will bend down and the person will be unable to straighten or move it, giving it the appearance of a mallet. 

In most situations its caused by accidentally hitting the tip of the straightened finger against a hard surface with the extensor tendon taught. This unexpected bang bends the DIP joint and breaks the attachment of the extensor tendon to the bone.

Common actions which can cause a Mallet finger injury are catching a ball, tucking in bedclothes and packing a suitcases.

Finger fractures, crush injuries and deep cuts can also cause Mallet finger.
Mallet Finger Injury
Complications
Avulsion

When the extensor tendon is suddenly pulled away from the finger bone it can sometimes take a small fragment of bone with it. This is known as an Avulsion. Very small Avulsions can still heal well if the finger is kept straight in a special splint for 6 to 8 weeks which is enough time to allow the tendon to re-attach onto the finger bone. 
Larger avulsions may require surgery to insert a K-wire through the bone and tendon to help it to re-attach correctly.
Controlled exercises are introduced when the tendon and bone fragment are strong enough to start moving again. This can vary slightly between individuals.

Time lapsed since injury

Acute
Although a person recognises that something is wrong with the tip of the finger they may not realise they have a Mallet finger injury straight away as the finger can swell and hide the problem. A Mallet finger injury is generally called acute up to 3 weeks after the accident and is managed non-surgically with a small finger splint.

3+ weeks
If treatment begins more than 3 weeks after the injury occurred, the condition is considered "chronic".  Successful outcomes will vary depending on whether surgery was required to ensure a strong attachment of the tendon to the bone. 
Mallet Finger Injury
What is the treatment?
The best results are achieved when the condition is identified as soon as possible and the finger tip splinted to keep the joint still during healing. 

Later the person will require advice on gently introducing light activities and will be prescribed specific exercises to strengthen the muscles after the splint is no longer needed. Specialised treatment, such as therapeutic ultrasound, can hasten recovery in some situations. 

Contact sports and manual working are not advised during the 6-8 weeks recovery time as the risk of detaching the repaired tendon remains high.  In fact, the standard issue A&E splint may not be accepted by some sports clubs or employers so it is always best to check your club or employer's policy about resuming activities while needing to wear a splint. 
Mallet Finger Injury
Hand Kinetics can help you
At Hand Kinetics you can expect your therapist to specialise in making customised hand and finger splints that are low profile and easy to wear. 

It may be possible to return to sport or work sooner but only with a strong Mallet finger splint to protect the tendon while it is still fragile but this depends on the individual and the stage of healing.

Unfortunately, it is not advisable to return to manual work or contact sports until your tendon is well healed. In some cases, a small lag may persist in the joint and exercises will need to be prescribed or a referral made to check the tendon attachment. 

If you need any other treatment to aid recovery we are able to address this immediately so your finger recovers in the shortest time possible.

Hand Kinetics Telephone: 0044 28 417 72301
www.handkinetics.com
contactus@handkinetics.com



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