Mallet Finger

Mallet finger is an injury to the tendon that straightens the tip of the finger. It usually occurs when the fingertip is forced to bend suddenly, damaging the tendon or pulling it away from the bone.

This results in an inability to fully straighten the end of the finger, which often appears drooped.

Mallet finger commonly occurs during sporting activities or minor trauma, such as catching a ball or striking the fingertip. Early treatment is important to restore function and prevent long-term deformity.

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Diagnosis is based on clinical assessment, including examination of finger movement.

The inability to actively straighten the fingertip is a key finding.

X-rays are often performed to check for an associated fracture or joint involvement.

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Treatment depends on the type of injury.

Most cases can be treated without surgery using:

• Continuous splinting of the fingertip to keep it straight
• Careful protection of the finger during healing

Splinting is usually required for several weeks without interruption.

In more complex cases, particularly where there is a fracture or joint involvement, surgical treatment may be recommended.

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Surgical treatment is considered in selected cases, particularly where there is a fracture involving the joint or instability.

The procedure may involve:

• Fixing the bone fragment
• Stabilising the joint

Surgery is typically performed as a day-case procedure.

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Recovery depends on the type of treatment.

For non-surgical treatment:

• The splint must be worn continuously for several weeks
• The fingertip must remain straight at all times during healing

Following surgery:

• A period of splinting may still be required
• Gradual return to movement under supervision

Full recovery may take several weeks, and adherence to treatment is essential for a good outcome.

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As with any surgical procedure, there are potential risks, although these are uncommon.

Possible complications include:

• Infection (around 1%), usually treated with antibiotics
• Swelling or stiffness, which may take time to settle
• Scar sensitivity
• Nerve irritation or injury (rare)
• Ongoing pain or discomfort, which typically improves over time
• Recurrence of symptoms (uncommon)
• Residual symptoms, particularly if the condition was advanced before treatment
• Persistent drooping of the fingertip
• Joint stiffness

Very rarely, a condition known as complex regional pain syndrome (CRPS) can occur, leading to prolonged pain and sensitivity.

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You should seek medical advice if you are unable to straighten the tip of your finger following an injury.

Early treatment is important, as delay can affect healing and long-term finger function.

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