What Is Mallet Finger?

Mallet finger, also known as baseball finger or drop finger, is when the tendon that connects the muscle to your finger bone is damaged. Mallet finger will leave the end of the finger drooped and curved inward toward the palm, unable to bend without help from your other hand. 

The injury occurs when the extensor tendon is ruptured or torn. The extensor tendon is what connects the forearm muscle to the finger bone. Sometimes a small piece of bone can detach with the tendon. This is called an avulsion injury.

Mallet finger is common in sports and happens when a ball comes in contact with the end of the finger at a high rate of speed (baseball, softball, basketball, or football). However, jamming your finger against any hard immovable object may cause the injury. Mallet finger may leave the finger bruised, swollen, painful and unable to bend.

Signs and Symptoms

The hallmark symptom of mallet finger is the drooping tip of the finger that bends inward toward the palm of the hand. The tip cannot be moved or bent back without help from your other hand. Other symptoms include:

• Pain
• Swelling
• Bruising
• Redness
• Tenderness or soreness

If you notice the fingernail is partially detached or there is blood under the nail, it may be due to a fracture or cut. It is important to seek medical help immediately, as it may lead to an infection.

Causes

Mallet finger is common in athletes but can happen to anyone when an extended finger comes in contact, forcefully, with a hard or immovable object. Mallet finger can also happen from a traumatic injury or accident, such as slamming a finger in a door.

Diagnosis 

A doctor will conduct a physical examination, specifically looking to see if you can bend the tip of your finger without help. Diagnosis can be made after a physical exam, and usually x-rays are ordered to make sure the bone hasn’t been pulled away, fractured, or is out of alignment. In rare cases, other imaging tests (MRI or CT scan) may be recommended.

Treatment

Nonsurgical

The majority of mallet finger injuries can be treated without surgery. It is important to seek medical care for this type of injury because if left untreated, mallet finger can lead to permanent stiffness or deformity of the finger. It is especially important in children because mallet finger can cause cartilage issues that may stunt bone growth in the finger if left untreated. 

Try to keep the finger elevated above your heart after the injury and use an ice pack to reduce swelling. Remove any rings on the injured finger, as the swelling may make it difficult to remove later, or it can also cut off blood flow. Anti-inflammatory medication can be taken for pain relief (Ibuprofen, Advil, etc.). You may continue using an ice pack for swelling and pain relief, as needed.

Treatment for mallet finger generally requires that the finger is splinted for 6-8 weeks and worn full-time for the first 3-4 weeks. The splint and skin under the splint will need to be cleaned once a day. It is critical that the splint be kept on at all times during the first 3-4 weeks, even while bathing. The only time the splint is removed is for cleaning the splint and finger once a day. It is imperative that the finger remain straight when taking the splint off to clean it, as any time spent bent may impair or prolong healing. 

In some cases, a doctor may have you schedule appointments over the 6-8 weeks to monitor the progress. If splinting is too hard for the patient, a doctor may have a temporary pin inserted at the end of the finger to hold it straight for 6-8 weeks. Most people after splinting will have normal functioning and appearance of the finger, however, some people may not regain full extension of the finger.

Surgical

Surgery to treat mallet finger is less common and is only done after careful consideration from you and your healthcare provider. Instances where surgery might be recommended include:

• Bone fracture
• Bone misalignment
• Bone fragments that make the joint unstable

To correct these types of issues, a surgeon would make a small incision into the finger and use a pin or wire to stabilize and straighten the finger, allowing the finger to heal. Your doctor may also give you exercises to do after the surgery to help strengthen the finger.