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Get the facts on Mallet Injury

What is a Mallet Injury?

It occurs when the tendon that straightens the joint at the end of the finger/thumb tears.

Signs and symptoms of a mallet injuries may include pain and swelling on the back of the finger across the DIP joint. The finger might also be tender to touch. The biggest sign is the inability to actively straighten the tip of the finger (DIPJ).

There are 2 types

  • Tendinous injuries (just affecting the tendon)
  • Bony injuries (when the tendon tears it pulls off a small fragment of bone).

How does it happen?

These types of injuries occur to patients both young and old. They mostly occur whilst doing daily routines (e.g. tucking in the bedsheets) or from a direct blow to the finger during ball sports (e.g., netball, basketball, cricket, or rugby).

What is the treatment?

A custom made splint is made to keep the end joint of the injured finger straight. The splint is worn full time for between 6-8 weeks.

Generally, it is 6 weeks for a bony mallet injury, and 8 weeks for a tendinous mallet injury.

What happens next?

Once the period of splinting has finished, your hand therapist will assess the finger for an extensor ‘lag’. They will check if the tendon and/or bony fragment have healed sufficiently to keep the end joint straight. If this is the case, a graded movement programme is undertaken whilst continuing to wear the splint for protective purposes. This normally takes about 2 weeks. Your hand therapist will closely monitor for any signs of lag whilst the tendon is being exercised.

Expected outcome?

Generally, mallet injuries heal very well and do not cause any long-term functional deficits or pain. Most people have full use of their finger affected finger/thumb at 10 weeks post treatment. Occasionally with a bony mallet injury, if the fragment of bone extends more than 30% of the joint surface it may require surgery. This would be decided by a Consultant Plastic or Orthopaedic Hand Surgeon.

How do I make an appointment?

If you are experiencing pain or swelling in your joint at the end of your finger, the hand therapists at The London Hand and Wrist Unit can guide you towards recovery. Please contact the unit on 020 3214 3617 or handunit@hcahealthcare.co.uk for an appointment.

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Get the facts on Mallet Injury
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