Mallet Finger (Hammer Finger)
What Is Mallet Finger?
The tendons that lift the fingertips (extensor digitorum communis, EPL) become very thin where they attach to the bones at the tips of the fingers. Mallet finger occurs when these tendons rupture, or when the tendon stays intact but pulls the bone away at its attachment site.
How Is Mallet Finger Diagnosed?
The tip of the affected finger droops downward, and there is swelling and pain at the outermost joint. The patient cannot actively lift the drooping fingertip.
If acute mallet finger caused by trauma is left untreated and the deformity persists for a long time, the finger joint just before it starts to bend downward.
How Does Mallet Finger Happen?
It is usually caused by minor injuries during everyday activities. Examples include the finger striking the wall while tucking a bed sheet in between the mattress and the wall, a basketball landing on the fingertip, or the fingertip catching on clothing while tucking it into your pants.
What Are the Treatment Options for Mallet Finger?
- Non-surgical treatment: this is based on immobilizing the drooping fingertip in a straight position after the injury.
- Surgical treatment: for injuries caused by tendon rupture, the mainstay of treatment should be non-surgical, using splinting. Surgery is rarely needed and involves stitching the tendon back to the area where it detached from the bone.
Surgery should be the first choice in patients whose injury is accompanied by a bony avulsion. The gold standard in surgical treatment is an indirect (closed) reduction maneuver using 2 K-wires, without opening the fracture line.
