Mallet Finger
DescriptionMallet finger is a finger deformity caused by a direct blow to the tip of the finger. The extensor tendon of the involved finger is disrupted at the DIP joint from the rupture of the distal phalanx where the extensor tendon attaches. It may also be caused by an avulsion fracture of the bone at the dorsal base of the distal phalanx.The result is a drop in the DIP joint.
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Signs & Symptoms
- Extensor lag or inability to actively extend the finger at the DIP joint
- Passive DIP extension is fully intact
- Acute phase: pain at the dorsal DIP joint, possible ecchymosis and edema
- History of a direct impact to tip of the finger
Diagnostic Tests
- X-ray of finger to identify fracture or dislocation
PT Implications
- Frequently treated with a simple finger splint.
- Splint to keep the DIP in slight hyperextension for approximately 8 weeks to provide the avulsion fracture or tendon rupture to heal.
- Change splint on a daily basis to reduce risk of skin breakdown. Must not bend finger during the healing process, therefore rest finger on a flat surface to maintain extension while changing the splint.
- Surgical repair for more severe fracture involving more than 1/3 of the joint surface or with a subluxed joint.