Advice from a Certified Hand Therapist: Mallet Finger
What is happening to my fingertip? It doesn’t go straight anymore.
If you can’t extend the tip of your finger, you may have what is called a mallet finger. This happens when the end of the tendon that lifts your fingertip becomes separated from the fingertip. There are a few different ways this can happen.
Do I need to do anything about this? Will it heal on its own?
If you have a mallet finger, it needs to be treated; it will not heal on its own. You should consult with your doctor, and possibly a hand surgeon.
A hand surgeon? That sounds serious!
It may be. Sometimes the tendon comes off the fingertip with a portion of the bone – sometimes it only comes partially off. Having a specialist assess it and direct you will ensure you have a good outcome.
So I’m going to have to have surgery to fix this?
Probably not. Most of the time, a mallet finger can be fixed by using an orthosis (or splint) that holds it straight for a several weeks; however, sometimes it can be more serious, which is why it is a good idea to have it professionally evaluated.
That sounds like it might be easy. I guess I’ll make an appointment to see my doctor when I get around to it.
Wait a minute! You want to get that taken care of sooner rather than later. A mallet finger that is more than a few weeks old before treatment starts can be harder to fix, so get it looked at quickly!
You said they will put it in a splint. Does that mean I won’t be able to use my finger for several weeks?
Actually, depending on your individual needs, the orthosis will be pretty small. It only restricts motion at the joint at the end of the finger – not the other joints of the finger – so you will still be able to move your finger a lot. Some orthoses are designed to sit on the fingernail side of the finger, which can allow a little more sensation on the pad of the finger for activities like typing. Other designs wrap around your finger, and in some cases, an actual cast is made. Again, the design depends on your particular needs. You can find a certified hand therapist who can help guide you to the right choice.
You know… this droopy finger thing really doesn’t bother me that much, and it sounds like a lot of effort to take care of it. I think I’ll just take my chances and not seek treatment.
That is an option you have; however, you should be aware of some possible problems that may come back to cause you grief. While that little droop may not bother you, it is changing the way your finger works. The tendons of your fingers are put together like a well-balanced system of levers and pulleys. When one pulley is not working correctly, it can impact the others. In the case of a mallet finger, this can result in a secondary deformity called a swan neck deformity. Just because you have a mallet finger does not mean you will develop a swan neck deformity – there are lots of factors at play – but it’s best to simply take care of the mallet finger.
Adam Holbrook, OTR/L, CHT is a certified hand therapist and a member of the American Society of Hand Therapists (ASHT).