This injury, which typically results from trauma, such as when the fingertip is hit by a ball, causes the tip of your finger to droop. Commonly an athletic injury, mallet finger occurs when the outermost joint of the finger is injured. The following rehabilitation program is a summary of the guidelines provided by hunter, mackin, callahan located in rehabilitation of the hand. Active pip flexion of affected finger with adjacent finger s held in extension.
Mallet finger also referred to as baseball finger occurs when an incident causes the extensor tendon at the tip of the finger or thumb to be stretched, cut or ruptured. Leroy young, md division of plastic surgery, washington university school of medicine, barnes hospital, st. Groth, otrlc, cht milliken hand rehabilitation center, barnes hospital, st. A mallet finger injury is a tear of the tendon that straightens the end joint of the finger. The tendon on the back of the joint snaps or pulls off its attachment to the bone. Here are some examples of exercises for you to try. The exercises may be suggested for a condition or for rehabilitation. Exercises improve movement and strength of your finger after this injury. Racgp mallet finger management and patient compliance. Basketball and baseball players routinely experience jammed fingers. Rehabilitation following mallet finger patient information what is mallet finger. Mallet finger therapy exercises things you didnt know.
When you do try to straighten it, the tip of your finger remains bent toward your palm. The patient with a chronic deformity is splinted longer than the patient with an acute deformity. Patient to perform daily skin check while keeping dip extended. There are finger exercises that a hand therapist can teach you to strengthen your fingers, but you should be evaluated by a hand surgeon to make sue there are no correctable injuries. Mallet finger advice on removal of your splint your tendon is becoming stronger but it is not fully healed. Typically, a ball or some object strikes the distal phalanx and forces it into hyperflexion while the extensor mechanism is active. The extension block technique for the treatment of mallet. Louis, missouri c ompliance has been defined as the. Mallet finger occurs when the tendon that straightens the last joint of your finger is torn. Rehabilitation after surgery for mallet finger focuses mainly on keeping the other joints mobile and preventing stiffness from disuse.
The tear may occur where the tendon joins onto the. The injury tears the tendon that straightens extends the end of the finger. Then wrap the finger with clean gauze or a clean cloth. Mallet finger injury often occurs in ballcatching sports such as football, basketball, baseball, and softball. Splint weaning program for mallet finger deformity after you have worn the mallet splint all the time for the recommended period, usually eight 8 weeks or longer, depending on what you were instructed, you should follow the weaning schedule below. The impact of cormpliance on the rehabilitation of. This condition is also known as baseball finger because it most often occurs when a ball or other object strikes the tip of a straight. The first type is called a bony mallet deformity which involves a fracture of the bone. You will not be able to straighten the end of your finger because the tendon connecting the muscle to the finger bone is stretched or torn. The injury can involve the tendon alone, or occur with a fracture at the tendonjoint interface fig. Mallet finger is an injury to the end of your finger that causes it to bend inwards towards your palm. In most of the cases, complete healing and functional restoration can be achieved by conservative treatment.
However, any action that bends the joint further than it is meant to bend can cause mallet finger. The general protocol for conservative treatment of a mallet finger is to splint the tip of the finger straight for approximately 68 weeks and then start to move it as long as it is stiff and does not droop. Mallet splint is worn at night but slowly discontinued during the day over a period of a week see weaning schedule below 8 weeks. It also tells you what you should and should not do. The term mallet finger has long been used to describe the deformity produced by disruption of the terminal extensor mechanism at the distal interphalangeal dip joint. The ishiguro technique for the treatment of mallet finger. The usual cause is an injury to the end of the finger.
Surgery to repair a mallet finger is required when the bone fragment is large, when the fingertip has moved position a little or when the cause is a laceration. The impact of compliance on the rehabilitation of patients with mallet finger injuries gail n. Mallet finger is a flexion deformity of the finger that results from injury to the extensor mechanism at the base of the distal phalanx. Sports injuries are a common cause of mallet finger. Mallet finger home program phase 2 exercises david gesensway, md notes. Mallet tendon rupture therapy the protocol for treating mallet fingers is the same whether the patient has required open reduction and internal fixation, percutaneous pin fixation, or is being treated nonoperatively. Splinting is the treatment of choice for almost all mallet finger injuries. The tendon that attaches to the tip of your finger bone on the back.
The result is the same, as the tendon then cannot pull on the bone. In this situation, the joint can be pushed straight, but will not hold that position on its own. This leaflet sets out some exercises you should do each day to help your finger to heal. Then gently try to straighten out the injured finger with help from your other hand. Sports injuries are the most common cause of mallet finger, particularly from catching a ball.
Also known as baseball finger, it is an injury that is typically sustained while playing sports. Mallet finger occurs when you cannot straighten your finger. Your physical therapist can design a program of physical therapy and exercise to assist in finger range of motion and to reduce joint stiffness. Repeat slowly, holding for 5 seconds at the end of each. This results in the inability to extend the finger tip without pushing it.
It is the most common closed tendon injury seen in athletes, although. The extension block technique for the treatment of mallet finger fracture. A mallet finger, also known as hammer finger, is an extensor tendon injury at the farthest away finger joint. Less often, the cause is a fracture at the bottom of the bone where the tendon attaches. With mallet finger, the tendon on the back of the finger not the palm side is separated from the joint it connects. Mallet finger refers to a condition in which the end joint of a finger bends but will not straighten by itself. Mallet finger rehabilitation protocol conservative management kelly holtkamp, m. Mallet deformity, rehabilitation, stiffness, fracture this is an open access article distributed under the terms of the creative commons attribution noncommercial. Mallet finger injury no splint treatment by hand exercises. When a ball or other object strikes the tip of the finger or thumb and forcibly bends it, the force tears the tendon that straightens the finger see figure 1a and 1b.
Dip 100 hyperextension for tendinous mallet 68 weeks. This is one of the few clinical entities in which the overwhelming evidence favors nonoperative treatment, even if slight subluxation of the dip joint is seen on. Sometimes the tendon does not tear but the injury causes a piece of bone to be pulled off the finger where the tendon is attached. Mallet finger is a condition in which the tendon in the outermost joint of a finger is ripped, causing the tip of the finger to droop. Mallet finger is a deformity caused by traumatic loss of continuity between the extensor apparatus and the distal phalanx. A mallet finger is a deformity of the finger caused when the tendon that straightens your finger the extensor tendon is damaged. Doctor answers on symptoms, diagnosis, treatment, and more.
Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb. Mallet finger occurs when there is a disruption in the tendon that straightens the tip of the finger. However, any injury that forces the end joint of a finger to overbend can cause it. Mallet injury conservative management baycare clinic. Mallet finger is a condition often seen after sports related trauma that causes the finger tip to droop, sometimes confused as a dislocation. If the finger is cut, clean the cut under running water for a few minutes. Review on mallet finger treatment article pdf available in hand surgery 173.
Full text full text is available as a scanned copy of the original print version. Surgery and therapy, mosby 1995 and handoll, vaghela, located in interventions for treating mallet finger injuries. The result of a mallet finger after injury is pain and swelling at the tip of the finger. After 8 weeks of continuous splint wear, and keeping the tip joint of the finger straight 24 hour a day protecting it in a straight position when cleaning the finger as well, you are ready to start the 2nd phase of.
It can involve either a bony avulsion injury of the distal phalanx or a rupture of the extensor tendon with no bony involvement figure 1. Mallet finger injuries physical therapy in corpus christi. Most mallet finger injuries can be managed nonsurgically, but occasionally surgery is recommended for either an acute or a chronic mallet finger or for salvage of failed prior treatment. Active pip flexion of affected finger with adjacent fingers held in extension. It is often caused by catching the finger end on during sport, but it sometimes results from a minor injury such as catching the finger when tucking in bed sheets. Mallet finger is an injury to the tip of the finger when something hard, like a baseball, jams it. When a ball or other object strikes the tip of the finger or thumb and forcibly bends it, the force tears the tendon that. It can occur in a number of ways, but most commonly when a straight finger is stubbed and forced to bend suddenly at the joint near the tip. Although it is also known as baseball finger, this injury can happen to anyone when an unyielding object like a ball strikes the tip of a finger or thumb and forces it to bend further than it. It will take a further six weeks before you can return to heavy activities. The single article published exclusively hand surgery service, maimonides medical center and center, state university of new york, brookn.
If swanneck deformity develops, reduce it passively. Mallet finger occurs when the outermost end joint of the finger is injured. Mallet fractures mallet finger occur at the insertion of the terminal finger extensor mechanism into the dorsal portion of the distal phalanx. Mallet splint is worn only at night and discontinued completely during the day if there is no extensor lag 9 weeks. Mallet finger is a flexion deformity resulting from avulsion of the extensor mechanism from the dip joint synonyms for this injury are baseball finger and drop finger, and jamming injuries in ball sports are common the anatomy of the dorsal apparatus of the fingers is complex and has generated detailed descriptions. Gently bend the injured finger with your other hand.
Although it is also known as baseball finger, this injury can happen to anyone when an unyielding object like a ball strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. The tendon is damaged, but no fractures bone cracks or breaks are present. Mallet finger fracture is a deformity produced by avulsion of the extensor tendon insertion at the base of the distal phalanx. There is generally pain and bruising at the back side of the farthest away finger joint. This can damage the tendon and bone, causing the finger to droop. Mallet finger rehabilitation protocol conservative management.
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