A really common injury that we see is what’s termed a mallet injury. This occurs when the extensor tendon that attaches to the dorsal side of the distal phalanx of your finger (just before your fingernail) is no longer able to straighten the end joint, known as the distal interphalangeal joint (DIP joint). This can occur playing sport, such as Aussie Rules or netball, or even just at home. Some of our clients have sustained this injury by simply bumping their finger when drying off with a towel, or hitting their finger on the Christmas ham! Other times it can be more traumatic, such as sustaining a deep laceration across the back of the finger.

This injury can be effectively treated conservatively. Occasionally surgery is required.

The injury can arise from damage to either the tendon, or the bone. If the mallet injury involves a bone fracture, this is generally called an avulsion fracture whereby the tendon pulls a piece of bone away. We would classify this as a ‘bony mallet injury’. If it is a large fragment or if the joint is not in good alignment, surgery could be necessary to realign the bone fragments and enable them to heal.

If the tendon itself is ruptured or cut, then it is called a ‘tendinous mallet injury.’ It is very important that we make this distinction as it affects your healing time. For that reason, an X-ray is always recommended.

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(image courtesy of www.patienteducation.co.uk)

Once it is established whether your mallet injury is bony or tendinous, we can get on with your treatment. The joint needs to be held in full extension for at least six weeks for a bony injury or eight weeks for a tendinous injury. We achieve this using – you guessed it – a thermoplastic splint. A small thermoplastic splint is moulded onto your finger immobilising just the DIP joint. Unlike many of our other splints, this splint is held on with sports tape as it’s not designed for frequent removal. Your finger needs to stay completely straight for the full period, or your healing time may be delayed. Your therapist will teach you how to safely remove your splint and clean your finger to ensure your skin stays healthy and hygienic.

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(Photo Copyright Riverina Hand Therapy)

After the prescribed six to eight weeks in the splint, your therapist will add some Velcro to your splint so that it is removable. This is necessary because your newly healed injury remains quite fragile, and needs to regain strength. It usually takes around two weeks to regain adequate strength to maintain good extension of your joint and be able to discard your splint.

Once you can take your splint off, your therapist will prescribe exercises to restore your normal movement and strength, and you will be back to normal in almost no time. 

If you think you have a mallet finger, let us know, we are the experts in treating mallet injuries.  Even it is is an old injury, there is still a chance we can correct it.