Mallet fingers often occur when the end of the finger is “jammed” against an object. The terminal extensor tendon tears and leaves the tip of the finger in a flexed (bent towards the palm) position. Initial treatment involves full-time splinting of the affected distal interphalangeal joint (joint directly adjacent to the fingernail) in a neutral position. Splinting aims to correct the flexed
posture. However, the skin should be monitored to ensure that splinting does not create excess pressure that may lead to sores. Eventually, under the guidance of a physician, splinting transitions to night-time only, followed by eventual discontinuation. After treatment, dorsal prominence of the joint and residual lag of the finger may occur. Arthritis may occur when there
is bone involvement. If a significant recurrent lag occurs immediately after splinting has been discontinued, the process of splinting is often repeated. Occasionally for very specific individuals/circumstances, surgery involving the placement of a temporary buried wire to maintain the joint in a neutral position may be performed. Outcomes after surgery vary and risks and benefits should be discussed in detail with your treating physician. Non-operative treatment also carries risks and benefits which should be discussed with your treating physician.
Disclaimer: This information is not intended to covey, substitute or supplant any medical advice. In order to establish a treating relationship, please schedule and complete your visits with a licensed physician.
Copyright 12/9/2021 Tanay Amin, MD
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