Complications of Mallet Finger
The complications of mallet finger can significantly affect hand function and quality of life if the condition is left untreated or if treatment is improperly followed.
Though many people think it is a minor injury, mallet finger can cause lasting deformity and functional problems. It may also damage the joint over time. Knowing about the complications of mallet finger helps patients get the right diagnosis, follow proper treatment, and stay committed to recovery.
This section explains both early and late complications. These include persistent drooping, joint instability, swan neck deformity, arthritis, and even emotional effects.
1. Persistent Flexion Deformity
The most common problem after mallet finger is a drooping fingertip. This happens when the tendon does not heal well, re-tears, or when splinting is not done correctly. A delay in treatment also makes the risk higher.
This deformity reduces grip strength and affects small tasks like typing or holding a pen. Even with correct treatment, some people still notice a slight droop. While it may not hurt, it can look odd. For those who want cosmetic or functional improvement, surgery may be an option.
2. Swan Neck Deformity
A serious complication of mallet finger is the swan neck deformity. It develops when the tip joint stays bent while the middle joint bends backward to compensate. This imbalance gives the finger a “swan neck” look.
The deformity makes gripping or straightening the finger hard. It can also change appearance and make simple tasks, like wearing gloves, difficult. Doctors may suggest custom splints or surgery to fix the joint balance and stop it from getting worse.
3. Joint Stiffness and Loss of Motion
Splinting is important, but long or tight splint use can stiffen the joint. Stiffness is worse if rehab exercises are skipped.
Patients may notice pain, difficulty bending or straightening, and trouble with tasks that need finger flexibility. Physical therapy after splinting is key to avoid stiffness. In severe cases, surgery or manipulation under anesthesia may be needed.
4. Chronic Pain and Swelling
Pain is not common with mallet finger, but some people develop ongoing discomfort. Causes include tight splints, bone fragments irritating soft tissue, or inflammation in the tendon or joint capsule.
Swelling that does not go away may signal scarring or inflammation inside the joint. If pain continues despite treatment, doctors may order an MRI or suggest surgery.
5. Osteoarthritis
When mallet finger heals poorly or remains untreated, the tip joint may wear down early. This leads to osteoarthritis.
Symptoms include morning stiffness, aching pain during activity, and bony growth around the joint. Motion becomes limited. Over time, arthritis can seriously affect hand function. Treatment may involve splinting, steroid injections, or in severe cases, joint fusion surgery to ease pain.
6. Nail Bed Deformities
Sometimes mallet finger also affects the nail bed. Pressure on the nail matrix can cause ridges, grooves, or discoloration. The nail may grow abnormally. Some patients also feel pain under the nail.
This happens more often in crush injuries or when splints press against the nail. Careful splint placement and regular checks can prevent this complication.
7. Infection
Infections may develop under the splint or after surgery, though this is rare. Warning signs include redness, warmth, pus, odor, and in severe cases, fever.
Poor hygiene, sweating under the splint, or open wounds usually cause infection. Treatment includes removing the splint, cleaning the skin, and starting antibiotics. Severe cases may need surgical cleaning. If not controlled, infection can delay healing or damage deeper tissues.
8. Re-Injury or Recurrence
Even after healing, the tendon can tear again. This usually happens when the finger is stressed too early. Sports and heavy work raise the risk, especially without protection.
If the tendon healed with weak scar tissue, it may also fail again. Re-injury often leads to drooping that is harder to fix a second time. For safety, athletes and manual workers should wear protective splints during risky tasks for weeks after recovery.
9. Surgical Complications
Surgery can help in difficult cases, but it comes with risks. Problems include poor wound healing, hardware irritation, failed fusion, infection, or nail damage. Some patients also notice numbness.
These risks show why careful surgical planning and follow-up are important. Most problems can be managed, but they often make recovery longer.
10. Psychological and Functional Impact
Mallet finger may also affect mental health. Visible deformity, reduced hand use, or cosmetic issues can cause embarrassment and low confidence. People who rely on fine motor skills may feel frustrated or even depressed.
Hand therapy and counseling help patients adjust and regain confidence. This is especially useful when changes in the finger are permanent.
Preventing Complications of Mallet Finger
Patients can lower risks by starting treatment quickly, ideally within a few days. They must follow splinting rules closely and avoid bending the finger during healing.
Good hygiene under the splint and regular doctor visits are important. After splinting, exercises restore movement and strength. For people in sports or manual work, protective gear reduces the chance of reinjury.
Education also matters. Patients who know the risks of mallet finger are more likely to follow treatment and notice problems early.
Final Thoughts on Complications of Mallet Finger
Mallet finger may look like a small injury, but the complications of mallet finger can last for years if ignored. Problems range from deformity and stiffness to chronic pain and arthritis.
With quick care, proper splinting, and rehab, most patients recover well. Guidance from skilled doctors and therapists ensures that complications are either avoided or managed. This allows people to return to normal hand use with little long-term effect.
