Emergency and Urgent Care - Mallet Finger

What is a Mallet Finger?

A mallet finger is where the end of a finger is bent (flexed) towards the palm and cannot be straightened.

What causes a Mallet Finger?

The usual cause is an injury to the end of the finger. The injury tears the tendon that straightens (extends) the end of the finger. Less often, the cause is a fracture at the bottom of the bone where the tendon attaches.

What is the treatment for Mallet Finger?

More commonly only the tendon is injured or the fracture fragment is very small. An operation to repair the injury is then not possible. Instead the joint must be held straight in a splint for about 6 weeks to help the tendon to heal.

The splint keeps the injured joint straight but allows the finger joints below it to move to stop them stiffening up. Even with splinting there is a chance that your finger will not be as straight as before but keeping it in the splint gives it the best chance possible.

It’s tempting to test how well your finger is healing by taking the splint off or bending the tip of your finger, this can cause further damage or delay healing.

Cleaning

The splinted finger must be kept clean and dry at all times. If the skin becomes wet inside the splint, it will become very sore and wounds may occur. It is important to wash both your finger and the splint at least once a day, following these instructions:

• Keeping your finger flat on the table, cut the strapping and slide the splint off your finger
• Wash and dry your finger and the splint using soap and water
• Keep the end joint straight at all times by keeping your finger flat on the table
• You may find it easier if someone helps you to do this as any movement of the end of the finger will delay healing of the tendon and may even cause permanent damage
• Slide the splint back over the fingertip, still keeping the finger straight
• Replace the strapping – this should cover the middle of the splint but should not cover the middle joint of the finger

Follow up

You will be provided with an appointment card with contact details for the Hand Therapy Clinic. Please telephone the given number and make yourself an appointment as soon as possible. The Hand Therapy Team will provide specialist follow up for your injury.

Summary

Do not:

• Try to test for healing by bending the fingertip
• Wear any rings on this hand until the injured finger has healed. This will help avoid swelling and problems with the blood supply to the fingers

Do:

• Keep your hand elevated if there is swelling and exercise all the joints except the splinted joint
• Keep your Hand Therapy Clinic appointment or phone to rearrange if you cannot make your given appointment

If you have any concerns please contact the Emergency department for further advice on:

Telephone: 0161 627 8926
The Royal Oldham Hospital, Rochdale Road, Oldham, OL1 2JH.