mallet finger

Etiology

• forced flexion of an extended finger at the distal interphalangeal joint

Epidemiology

• football players, baseball players, elderly women

Pathology

• deformity of a finger caused by an extensor tendon injury of the distal phalanx (baseball injury)

Clinical manifestations

• finger or thumb pain
• edema of thumb or finger
• persistence of terminal phalanx in flexed position
• the thumb or finger is unable to fully extend
• blood may collect under the fingernail

Radiology

• X-ray to rule out fracture or malalignment of joint

Complications

• avulsion injury may occur if the ligament in the distal phalanx is torn from its insertion site, resulting in a fracture
• non-compliance with immobilization is the most common obstacle to fully recovery & most patients will retain some residual 'droop'

Management

• a splint to hold the fingertip in extension
  • full time for 6-8 weeks
  • over the next 3-4 weeks, most patients gradually begin to wear the splint less frequently
  • follow-up woth occupational therapy
• surgical repair
  • large fracture fragments or joint malalignment
  • nonsurgical treatment failure

More general terms

• joint disease; articular disease; arthropathy
• finger injury