A mallet finger is an abnormality that occurs when the finger joint closest to the fingernail is injured. This injury most often occurs while playing sports such as baseball and basketball, but mallet finger also can be caused by crushing or cutting injuries that happen at home or work. Sometimes this condition can be treated at home, but severe cases might require medical treatment. All cases should be evaluated by a doctor to determine what kind of treatment is needed.
There are three main types of mallet injury. In one type, the finger tendon is damaged. In the second, the tendon is damaged and the bone has sustained a small fracture. The third, most severe type of injury causes tendon damage and a large bone fracture. All three types of injury immediately cause pain, tenderness and swelling at the injured joint. The finger will redden and become more swollen over the next few hours, and it will not be possible to extend the finger.
A person who sustains a mallet finger injury should seek a doctor’s advice immediately, or as soon as possible, after the injury. A doctor must evaluate the injury to determine whether tests are needed before starting treatment. For example, if a doctor suspects the bone is fractured, he or she will order an X-ray to check the location and extent of the fracture. In cases of severe injury, the doctor might refer the patient to a hand surgeon or to an emergency department for immediate treatment.
When a mallet finger injury occurs at home, some immediate treatment can be applied. Ice can be applied to the finger by wrapping ice or a bag of frozen vegetables in a towel and holding the bundle against the injury. If the finger has been cut, it should first be held under running water for several minutes, then wrapped with a clean cloth or gauze. In all cases, it is very important to take care that the finger is not injured further by forcing movement or handling the finger roughly. This treatment should be followed up by a visit to the doctor.
A doctor usually will treat this injury by splinting the finger to help it remain extended and promote healing of the tendon. This treatment generally is sufficient for most injuries; it is only when the bone fracture is moderate or large in size that further treatment is necessary. Depending on the injury, a doctor might also stitch the tendon or the skin to help the finger heal. Over-the-counter medications or prescription medications can be used to manage the pain.
If the bone fracture is large or damage to the tendon is significant, mallet finger surgery might be performed. In cases of severe damage, surgery provides the best chance that the finger can be repaired. Surgery to repair a mallet injury is often carried out by a specialist surgeon who will evaluate the injury and decide the best repair method prior to the procedure.