Mallet finger - aftercare

More about Your Injury

Tendons attach muscles to bones. The tendon that attaches to the tip of your finger bone on the back side helps you straighten your fingertip.

A mallet finger occurs when this tendon:

• Is stretched or torn
• Pulls a piece of bone away from the rest of the bone (avulsion fracture)

Mallet finger most often occurs when something hits the tip of your straightened finger and bends it down with force.

What to Expect

Wearing a splint on your finger to keep it straight is the most common treatment. You may need to wear the splint for different lengths of time.

• If your tendon is only stretched, not torn, it should heal in 4 - 6 weeks wearing a splint all the time.
• If your tendon is torn or pulled off the bone, it should heal in 6 - 8 weeks of wearing a splint all the time. After that, you will need to wear the splint for another 3 - 4 weeks at night only.

If you wait to start treatment, you may have to wear your splint longer. Surgery is almost never needed except for more severe fractures.

Your splint is made out of hard plastic or aluminum. A trained professional should make your splint to make sure it fits correctly and your finger is in the right position for healing.

• It should be snug enough to hold your finger in a straight position so that it does not droop, but not too tight so that it cuts off the blood flow.
• If your skin is white when you take off your splint, your splint may be too tight.

Activity

You will likely be able to return to your normal activities or sports, as long as you wear your splint all the time.

Self-care at Home

Be careful when you take off your splint to clean it.

• Keep your finger straight the whole time the splint is off.
• Letting your fingertip droop or bend may mean you will have to wear your splint even longer.

When you shower, it is a good idea to cover your finger and splint in plastic. If they get wet, dry them after your shower. Be careful to keep your finger straight while you are drying it.

Using an ice pack can help for pain. Apply the ice pack 20 minutes of every hour you are awake for the first 2 days, then 10 - 20 minutes 3 times daily as needed to reduce pain and swelling.

You can also try pain medicines such as ibuprofen, naproxen, or acetaminophen.Talk with your health care provider if you have:

• Heart disease or high blood pressure
• Kidney disease
• Had stomach ulcers or internal bleeding
• Liver disease

Do not take more than the amount recommended on the bottle.

Follow-up

When it is time for your splint to come off, your health care provider will check how well your finger has healed.

• Swelling in your finger when you are no longer wearing the splint may be a sign the tendon has not healed yet.
• You may have another x-ray of your finger.

If you finger has not healed at the end of your treatment, your health care provider may recommend another 4 weeks of wearing the splint.

When to Call the Doctor

Call your doctor if:

• Your finger is still swollen at the end of your treatment time.
• Your pain gets worse at any time.
• The skin of your finger changes color or you develop numbness or tingling in the finger.

Alternate Names

Baseball finger; Drop finger; Avulsion fracture - mallet finger

References

Sokolove PE. Extensor and flexor tendon injuries in the hand, wrist, and foot. Roberts J, Hedges J, eds. Roberts: Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 48.

Update Date: 6/19/2012

Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.