Treatment of Mallet Finger
The treatment of mallet finger focuses on restoring fingertip function and alignment. It prevents long-term deformity and protects hand dexterity. While the injury may look small, late or incorrect care can cause permanent stiffness or dysfunction. The good news is that most cases respond well to simple, non-surgical care when treated early.
This section explains the options for the treatment of mallet finger. It covers splinting, surgery, rehabilitation, and long-term follow-up.
Conservative Treatment (Splinting)
The most common treatment of mallet finger is splinting. Doctors use it in about 90% of cases, especially when no major bone fragment or joint shift is present.
Types of splints include:
- Stack splint (plastic): Keeps the tip joint extended.
- Custom thermoplastic splints: Made for a precise fit.
- Aluminium-foam splints: Affordable but less durable.
Splinting procedure:
The tip joint is gently straightened, sometimes slightly hyperextended. The splint holds the joint in this position at all times. Patients must wear it day and night for 6–8 weeks. The finger should never bend during this time, as even one slip can restart healing from the beginning.
Care tips:
- Keep the skin under the splint clean and dry.
- Watch for redness, swelling, or sores.
- Attend weekly checkups to track healing.
Splinting works well for tendon injuries and small fractures that are not displaced.
Weaning from the Splint
After 6–8 weeks of strict splinting, patients begin weaning. For 2–4 weeks, the splint is worn only at night. During the day, light finger use starts.
A home program of simple exercises restores mobility. Patients must avoid sudden strain or bending the finger too far. Overuse at this stage can tear the tendon again.
Surgical Treatment of Mallet Finger
Surgery is rarely needed, but it becomes important in certain cases. These include large bone fragments, joint dislocation, open cuts with tendon injury, failure of splinting after 2–3 months, or long-standing deformities that affect hand use or appearance.
Surgical methods include:
- Pinning (K-wire): A small pin holds the joint straight while healing.
- Tendon repair: Stitches close a cut tendon.
- Fracture fixation: Tiny screws or wires secure bone fragments.
- Joint fusion (arthrodesis): Used in chronic or arthritic cases to fuse the joint slightly extended.
Surgery can give good results but carries risks such as infection, stiffness, or scarring. Recovery also takes longer compared to splinting.
Pain Management
Pain from mallet finger is usually mild. Relief comes from paracetamol or NSAIDs like ibuprofen, cold packs applied for 15–20 minutes, and hand elevation to reduce swelling.
If pain remains strong or increases, it may point to splint problems, infection, or another injury. In such cases, patients should see a doctor.
Physical Therapy and Rehabilitation
After splinting ends, therapy is vital to regain motion and strength. A therapist may guide:
- Gentle range-of-motion drills.
- Strengthening of the extensor tendon.
- Massage or desensitisation if the skin or nail bed was injured.
- Monitoring for stiffness or swan neck deformity.
Therapy should be slow and controlled. Doing too much too soon often sets recovery back. For people like musicians or artisans, therapy is tailored to their work needs.
Home Care and Patient Education
Success in the treatment of mallet finger depends on strict patient effort. At home, patients must:
- Wear the splint exactly as told.
- Keep the area clean.
- Report swelling, numbness, or new deformity.
- Avoid heavy use of the finger during healing.
Education is key. Many people believe the injury is “not serious.” In truth, ignoring it can leave the finger with a permanent droop, pain when gripping, or problems with writing, typing, and tool use.
Follow-Up and Monitoring
Even after healing looks complete, checkups are important. They confirm the joint remains stable and check for swan neck deformity. They also help detect recurrence or complications.
Doctors may also give advice about safe return to sport or manual work. If symptoms remain, further imaging or even surgery may be needed.
Prognosis After Treatment of Mallet Finger
With correct and early treatment, the outlook is excellent. Most patients regain full function. A small droop may stay but is usually painless and only cosmetic.
When splinting is done correctly from the start, surgery is rarely needed. However, delays, poor splinting habits, or complex fractures raise the risk of long-term stiffness, arthritis, or deformity.
Summary
The treatment of mallet finger depends on quick diagnosis, proper splinting, and patient discipline. Surgery plays a role only in more complex cases. Long-term results rely on how early and consistently treatment is applied. With the right care, most people regain almost full use of the finger and avoid permanent damage.
