Jordan Smith, one of our physio team at Blackberry Clinic Milton Keynes, sees a variety of injuries at the clinic. Some of them involve the smaller joints of the body such as the injury which he describes here:
Mallet finger is the term applied to extensor avulsion fractures or distal extensor tendon ruptures. Either one results in an inability to extend the distal interphalangeal joint.
Terminal extensor tendon injuries represent 5.6% of injuries in the hand and wrist.
Mallet finger injuries:
· Usually occur in the workplace or during sports-related activities
· Are frequently seen in young to middle-aged men and occasionally in older women as well. The mean age for men with a mallet finger injury is 34 years. The mean age for women is 41 years.
· Are more common in ball sports, as the ball hits the fingertip of an extended finger. This compels the distal interphalangeal joint into a forced flexion position and thereby causes an extensor tendon disruption
· Terminal extensor tendon injuries can also occur with lower injury impacts – such as an elderly person “jamming” their finger while performing activities of daily living such as pulling up socks or tucking in bedsheets
· The fingers most commonly affected are the middle finger and the ring finger of the dominant hand
Symptoms
Initially, the finger is painful and swollen around the DIP joint. When the actual tendon is ruptured, the condition can be relatively painless. If a piece of the bone is pulled off, it is normally a bit more swollen and sore. The end of the finger is bent and cannot be straightened voluntarily. The DIP joint can be straightened easily with help from the other hand.
Treatment
In general, a splint will be worn full time for 6–8 weeks. Then exercises can commence to gradually increase the movement in the tip of the finger. The time in which the individual is in the splint for can then gradually reduce. It usually takes around 3–4 weeks to regain maximal movement and strength of the finger post-immobilisation. Surgery to repair a mallet finger is required when the bone fragment is large, when the fingertip has moved position a little or when the cause is a laceration.
Mallet finger is often harmless and not hugely disabling. However, should you sustain such injury, it is recommended you seek professional advice from one of our physios at a Blackberry Clinic near you.
