Mallet Finger: Symptoms, Causes, Treatment

What are the symptoms of mallet finger?

Mallet finger, also known as dropped finger or jersey finger, is a common injury that occurs when the extensor tendon of the finger becomes damaged, causing the tip of the finger to droop or drop. The symptoms of mallet finger typically develop within a few hours to several days after the injury and may include:

1. Drooping or dropping of the fingertip: The affected finger may droop or drop due to the loss of extensor tendon function.
2. Swelling and bruising: The finger may become swollen and bruised due to bleeding and inflammation.
3. Pain: Pain or tenderness in the affected finger, particularly at the base of the finger or on the back of the hand.
4. Limited range of motion: The affected finger may have limited mobility or stiffness, making it difficult to bend or straighten.
5. Bowing or curving: The affected finger may bow or curve due to the imbalance of muscle forces.
6. Decreased grip strength: The injured finger may not be able to grip objects as firmly due to weakness in the hand muscles.
7. Numbness or tingling: Some people may experience numbness or tingling sensations in the affected finger due to compression of nerves.

If left untreated, mallet finger can lead to chronic pain, limited range of motion, and permanent deformity. It’s essential to seek medical attention if you experience any symptoms of mallet finger, especially if you have a high-impact injury or if you have difficulty moving your fingers.

Treatment for mallet finger typically involves immobilization in a splint or cast for 6-8 weeks to allow the tendon to heal. In some cases, surgery may be necessary to repair the damaged tendon.

What are the causes of mallet finger?

Mallet finger, also known as dropped finger or jersey finger, is a common injury that occurs when the extensor tendon of the finger becomes damaged, causing the tip of the finger to droop or drop. The causes of mallet finger can be classified into two main categories:

Acute injuries:

1. Trauma: A direct blow to the finger, such as a fall or a sports injury, can cause the extensor tendon to rupture.
2. Lacerations: A cut or laceration on the finger can cause damage to the extensor tendon.
3. Crush injuries: Crushing injuries, such as those caused by a car door or a heavy object, can damage the extensor tendon.
4. Finger bending or twisting: Forcing the finger to bend or twist beyond its normal range of motion can cause the extensor tendon to rupture.

Chronic conditions:

1. Tendonitis: Repeated strain or inflammation of the extensor tendon can lead to weakening and eventual rupture.
2. Osteoarthritis: Wear and tear on the joints of the fingers can cause degeneration of the extensor tendon.
3. Rheumatoid arthritis: Inflammation and swelling in the joints and tendons can lead to damage to the extensor tendon.
4. Cervical spine conditions: Conditions such as cervical spine stenosis or spondylolisthesis can cause compression of the nerves that control the fingers, leading to weakness and instability in the fingers.

It’s essential to seek medical attention if you experience any symptoms of mallet finger, especially if you have a high-impact injury or if you have difficulty moving your fingers. Early treatment can help prevent chronic complications and promote optimal healing.

How is the diagnosis of mallet finger made?

The diagnosis of mallet finger is typically made through a combination of physical examination, medical history, and imaging studies. Here’s a step-by-step approach to diagnosing mallet finger:

1. Physical examination: A thorough physical examination is performed to assess the affected finger, including:
   • Visual inspection: The doctor examines the finger for signs of injury, such as swelling, bruising, or deformity.
   • Palpation: The doctor feels the finger to detect any tenderness or swelling.
   • Range of motion: The doctor assesses the finger’s range of motion, including flexion, extension, and rotation.
2. Medical history: The doctor takes a detailed medical history to understand the onset and nature of the symptoms, including:
   • Date and mechanism of injury
   • Nature and severity of pain or discomfort
   • Presence of any previous injuries or medical conditions
3. Imaging studies: Imaging studies may be ordered to confirm the diagnosis and rule out other conditions, including:
   • X-rays: To assess the bone structure and rule out fractures or osteoarthritis.
   • MRI (Magnetic Resonance Imaging): To evaluate soft tissue structures, such as tendons and ligaments.
   • CT (Computed Tomography) scan: To assess bone and joint alignment.
4. Provocative testing: The doctor may perform provocative tests to evaluate the extent of damage to the extensor tendon and surrounding tissues, including:
   • Tinel’s sign: A test to assess nerve compression or entrapment.
   • Phalen’s maneuver: A test to assess compression of the median nerve.
5. Specialized tests: In some cases, specialized tests may be performed to evaluate specific aspects of the injury, such as:
   • Electromyography (EMG): To assess muscle function and nerve conduction.

The diagnosis of mallet finger is typically made based on a combination of these findings. If the diagnosis is uncertain, further testing or consultation with a specialist may be necessary.

What is the treatment for mallet finger?

The treatment for mallet finger typically involves a combination of immobilization, pain management, and physical therapy to promote healing and restore function. The specific treatment plan may vary depending on the severity of the injury, the individual’s overall health, and the presence of any underlying medical conditions. Here are some common treatment options for mallet finger:

Immobilization:

1. Splinting: A splint is applied to immobilize the affected finger in a neutral position to prevent further injury and promote healing.
2. Cast: A cast may be applied to immobilize the entire hand or finger, depending on the severity of the injury.

Pain management:

1. Medications: Over-the-counter pain relievers such as acetaminophen or ibuprofen may be prescribed to manage pain and inflammation.
2. Topical creams: Topical creams or ointments containing capsaicin or lidocaine may be applied to the affected area to relieve pain and reduce inflammation.

Physical therapy:

1. Range of motion exercises: Gentle exercises are performed to maintain and improve range of motion in the affected finger.
2. Strengthening exercises: Strengthening exercises are performed to improve muscle strength and stability in the hand and fingers.
3. Sensory re-education: Sensory re-education techniques may be used to improve sensation and proprioception (position sense) in the affected finger.

Surgery:

1. Tendon repair: In some cases, surgery may be necessary to repair a torn tendon.
2. Tendon grafting: A tendon graft may be used to repair a severely damaged tendon.

Rehabilitation:

1. Progressive strengthening: Progressive strengthening exercises are performed to gradually increase strength and stability in the affected finger.
2. Functional activities: Functional activities such as gripping, grasping, and manipulating objects are gradually introduced to promote functional recovery.

It’s essential to follow a consistent treatment plan and attend regular follow-up appointments with a healthcare provider to monitor progress and adjust the treatment plan as needed.