Mallet finger

Mallet finger, also known as baseball finger or drop finger, is a condition characterized by the inability to straighten the end joint of a finger. It typically occurs due to an injury to the extensor tendon that controls the finger's ability to straighten. Understanding the causes, symptoms, and treatment options for mallet finger can help individuals manage this condition effectively.

Definition

Mallet finger is a deformity of the finger caused by a rupture or avulsion of the extensor tendon at the distal interphalangeal (DIP) joint. This injury prevents the affected finger from fully extending, resulting in a drooping or bent appearance at the end joint.

Causes

Common Causes of Mallet Finger:

• Trauma: Direct trauma to the fingertip, such as a blow or impact while playing sports, jamming the finger, or catching it on an object.
• Forceful Flexion: Forceful bending of the fingertip, leading to overstretching or tearing of the extensor tendon.
• Lacerations or Cuts: Deep cuts or lacerations near the DIP joint can damage the extensor tendon.

Symptoms

Signs and Symptoms of Mallet Finger:

• Inability to Straighten the Finger: The end joint of the finger remains bent or droops downward.
• Pain and Swelling: Pain and swelling around the DIP joint, especially immediately after the injury.
• Tenderness: Tenderness to touch at the site of the injury.
• Bruising: Bruising or discoloration of the skin around the DIP joint may occur in some cases.

Diagnosis

Diagnosing Mallet Finger:

1. Physical Examination: Assessment of the finger's range of motion, stability, and appearance.
2. X-rays: Imaging studies may be ordered to assess the severity of the injury and evaluate for any associated fractures or dislocations.
3. Clinical History: Discussion of the circumstances surrounding the injury and any previous hand injuries or conditions.

Classification

Classification of Mallet Finger:

• Type I: Closed injury with a bony avulsion or fracture at the base of the distal phalanx.
• Type II: Closed injury with rupture or avulsion of the extensor tendon without a bony fragment.
• Type III: Open injury with soft tissue loss or exposure of the extensor tendon.

Treatment

Treatment Options for Mallet Finger:

Non-Surgical Treatment:

• Splinting: Immobilization of the finger in a splint or brace to keep the DIP joint in a straight position for 6 to 8 weeks.
• Buddy Taping: Taping the injured finger to an adjacent finger for additional support and stability.

Surgical Treatment:

• Open Reduction and Internal Fixation (ORIF): Surgical repair of the tendon or fracture with the use of pins, wires, or screws.
• Tendon Repair: Surgical repair of the torn or ruptured extensor tendon to restore function and stability.
• Skin Grafting: For open injuries involving soft tissue loss or skin defects.

Complications

Potential Complications of Mallet Finger:

• Swan Neck Deformity: Hyperextension of the proximal interphalangeal (PIP) joint and flexion of the DIP joint due to imbalance in tendon function.
• Joint Stiffness: Reduced range of motion or stiffness in the affected finger, especially if immobilization is prolonged.
• Chronic Pain: Persistent pain or discomfort, particularly if the injury does not heal properly or if there are associated fractures or dislocations.

Rehabilitation

Rehabilitation and Physical Therapy:

• Gradual Mobilization: Gradual mobilization of the affected finger through gentle range of motion exercises under the guidance of a hand therapist.
• Strengthening Exercises: Progressive strengthening exercises to improve grip strength and finger function.
• Functional Training: Training in activities of daily living to restore normal hand function and dexterity.

Prevention

Preventive Measures for Mallet Finger:

• Protective Gear: Wearing protective gloves or splints during sports or activities that pose a risk of finger injury.
• Proper Technique: Using proper technique and form during sports or activities to minimize the risk of finger trauma.
• Avoiding Forceful Bending: Being cautious when handling heavy objects or when performing tasks that require forceful bending of the fingers.

Prognosis

Prognosis for Mallet Finger:

• Non-Surgical Treatment: With appropriate splinting and immobilization, many cases of mallet finger can heal without the need for surgery, although full recovery may take several weeks.
• Surgical Treatment: Surgical repair may be necessary for more severe or complex injuries, with outcomes dependent on the extent of the injury and the success of surgical intervention.

Conclusion

Mallet finger is a common hand injury characterized by the inability to straighten the end joint of the finger due to damage to the extensor tendon. Prompt diagnosis and appropriate treatment, whether non-surgical or surgical, can help individuals achieve optimal outcomes and restore finger function. Understanding the causes, symptoms, and treatment options for mallet finger is essential for effective management and prevention of complications