Mallet finger (T&O)

What is a mallet finger?

You have torn the tendon which straightens the end joint of your finger. The tendon may also have pulled off a small fragment of bone. Your finger tip is drooping because the tendon used to straighten it has snapped. This is called ‘mallet finger’.

It is often caused by catching the finger “end-on” during sport, but it sometimes results from a minor injury such as catching the finger when tucking in bed sheets. The tendon may tear where it joins on to the end or may pull off a small piece of bone at this point (if this happens, this is called a ‘mallet fracture’).

To treat this injury the finger must be held straight in a splint to allow the tendon to heal. The splint is worn continuously for six to eight weeks (or sometimes a shorter period for mallet fractures, which can heal more quickly than tendon tears). It is very important that the end joint does not bend during the splinting treatment period. The splint will allow the tip of the finger to be kept extended when the hand is in use. At the end of this time the splint is worn for one to two weeks at night and whenever the finger might be at risk of injury.

Swelling and bruising at the fracture site is normal. Simple, over the counter pain killers will help to reduce swelling and pain.

Cleaning

The splint needs to be taken off daily to clean your finger and the splint. If not, the splint will start to smell.

When you remove the splint to wash the finger, you must hold it straight on a flat surface and not allow it to bend. You will be shown how to change the splint safely. Healing may be delayed or may not occur at all if the finger is allowed to bend.

Most injuries treated by splinting will heal satisfactorily leaving normal function in the affected finger. There may be slight loss of full straightening at the completion of treatment, and it may take several months to regain satisfactory function. Redness, swelling and tenderness of the skin on top of the end joint are common for three or four months after injury, but usually settle down eventually.

Mallet fractures may leave a small bump on the top of the end joint and slight loss of bending of the joint, but pain is rare and the finger generally functions well.

Occasionally the tendon fails to repair itself. It can be treated by a further period of splinting. Surgical repair can be attempted, but the results are not consistently good.

You should:

• keep your hand elevated, exercising all the joints except for the end joint of the splinted finger.
• check your skin regularly to monitor for any sores developing under the splint.

You should not:

• wear any rings on this hand until the injured finger has healed. All rings should be removed at the time of injury to avoid swelling and circulatory problems.
• miss any appointments with the specialist if these have been requested.

Please remember:

Please contact your GP if your condition is not improving, or if your pain relief is not adequate.

If your condition is worsening please contact the Multi professional fracture clinic, call 01223 348299 or call 01223 257095.

For more information please visit the Fracture Info website (opens in a new tab).

For any concerns on wounds email CUH fracture info.

Please include your hospital number and any photos of your wounds that you would like to be reviewed.