Mallet finger is an injury to the end of your finger that causes it to bend inwards towards your palm. Mallet finger refers to a condition in which the end joint of a finger bends but will not straighten by itself. There are finger exercises that a hand therapist can teach you to strengthen your fingers, but you should be evaluated by a hand surgeon to make sue there are no correctable injuries. The patient with a chronic deformity is splinted longer than the patient with an acute deformity. The following rehabilitation program is a summary of the guidelines provided by hunter, mackin, callahan located in rehabilitation of the hand. The impact of compliance on the rehabilitation of patients with mallet finger injuries. The impact of compliance on the rehabilitation of patients with mallet finger injuries gail n. The result is the same, as the tendon then cannot pull on the bone. When a ball or other object strikes the tip of the finger or thumb and forcibly bends it, the force tears the tendon that. However, any action that bends the joint further than it is meant to bend can cause mallet finger. 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. This is one of the few clinical entities in which the overwhelming evidence favors nonoperative treatment, even if slight subluxation of the dip joint is seen on. In most of the cases, complete healing and functional restoration can be achieved by conservative treatment. Mallet finger occurs when there is a disruption in the tendon that straightens the tip of the finger.
Sports injuries are the most common cause of mallet finger, particularly from catching a ball. It can occur in a number of ways, but most commonly when a straight finger is stubbed and forced to bend suddenly at the joint near the tip. Sports injuries are a common cause of mallet finger. Commonly an athletic injury, mallet finger occurs when the outermost joint of the finger is injured. Your physical therapist can design a program of physical therapy and exercise to assist in finger range of motion and to reduce joint stiffness. The result of a mallet finger after injury is pain and swelling at the tip of the finger. Mallet finger occurs when you cannot straighten your finger. Mallet deformity, rehabilitation, stiffness, fracture this is an open access article distributed under the terms of the creative commons attribution noncommercial. When the tendon is damaged, cut, or avulsed ripped from bone the tip of the finger will drop down without the ability to straighten. The tear may occur where the tendon joins onto the. After 8 weeks of continuous splint wear, and keeping the tip joint of the finger straight 24 hour a day protecting it in a straight position when cleaning the finger as well, you are ready to start the 2nd phase of.
Mallet finger home program phase 2 exercises david gesensway, md notes. It can involve either a bony avulsion injury of the distal phalanx or a rupture of the extensor tendon with no bony involvement figure 1. Active pip flexion of affected finger with adjacent finger s held in extension. The injury tears the tendon that straightens extends the end of the finger. Mallet splint is worn at night but slowly discontinued during the day over a period of a week see weaning schedule below 8 weeks. Mallet fractures mallet finger occur at the insertion of the terminal finger extensor mechanism into the dorsal portion of the distal phalanx. The injury can involve the tendon alone, or occur with a fracture at the tendonjoint interface fig. It is the most common closed tendon injury seen in athletes, although. Review on mallet finger treatment article pdf available in hand surgery 173. Mallet injury conservative management baycare clinic. Also known as baseball finger, it is an injury that is typically sustained while playing sports. It will take a further six weeks before you can return to heavy activities. Mallet finger is an injury to the tip of the finger when something hard, like a baseball, jams it.
Rehabilitation following mallet finger patient information what is mallet finger. Mallet finger injury no splint treatment by hand exercises. A mallet finger injury is a tear of the tendon that straightens the end joint of the finger. In this situation, the joint can be pushed straight, but will not hold that position on its own. A mallet finger, also known as hammer finger, is an extensor tendon injury at the farthest away finger joint.
This results in the inability to extend the finger tip without pushing it. Full text full text is available as a scanned copy of the original print version. Mallet finger injury often occurs in ballcatching sports such as football, basketball, baseball, and softball. The general protocol for conservative treatment of a mallet finger is to splint the tip of the finger straight for approximately 68 weeks and then start to move it as long as it is stiff and does not droop. Most mallet finger injuries can be managed nonsurgically, but occasionally surgery is recommended for either an acute or a chronic mallet finger or for salvage of failed prior treatment. Sometimes the tendon does not tear but the injury causes a piece of bone to be pulled off the finger where the tendon is attached. When a ball or other object strikes the tip of the finger or thumb and forcibly bends it, the force tears the tendon that straightens the finger see figure 1a and 1b. Racgp mallet finger management and patient compliance. Doctor answers on symptoms, diagnosis, treatment, and more. When you do try to straighten it, the tip of your finger remains bent toward your palm. The tendon that attaches to the tip of your finger bone on the back.
The term mallet finger has long been used to describe the deformity produced by disruption of the terminal extensor mechanism at the distal interphalangeal dip joint. A mallet finger is a deformity of the finger caused when the tendon that straightens your finger the extensor tendon is damaged. Mallet finger is a condition in which the tendon in the outermost joint of a finger is ripped, causing the tip of the finger to droop. Leroy young, md division of plastic surgery, washington university school of medicine, barnes hospital, st. Mallet finger fracture is a deformity produced by avulsion of the extensor tendon insertion at the base of the distal phalanx.
With mallet finger, the tendon on the back of the finger not the palm side is separated from the joint it connects. The exercises may be suggested for a condition or for rehabilitation. It also tells you what you should and should not do. Basketball and baseball players routinely experience jammed fingers. The injury may involve just the terminal extensor tendon or phalangeal. This leaflet sets out some exercises you should do each day to help your finger to heal. Surgery and therapy, mosby 1995 and handoll, vaghela, located in interventions for treating mallet finger injuries. Typically, a ball or some object strikes the distal phalanx and forces it into hyperflexion while the extensor mechanism is active. Although it is also known as baseball finger, this injury can happen to anyone when an unyielding object like a ball strikes the tip of a finger or thumb and forces it to bend further than it. Here are some examples of exercises for you to try. Mallet finger occurs when the tendon that straightens the last joint of your finger is torn.
Splint weaning program for mallet finger deformity after you have worn the mallet splint all the time for the recommended period, usually eight 8 weeks or longer, depending on what you were instructed, you should follow the weaning schedule below. There is generally pain and bruising at the back side of the farthest away finger joint. Then gently try to straighten out the injured finger with help from your other hand. Mallet finger injuries physical therapy in corpus christi. Groth, otrlc, cht milliken hand rehabilitation center, barnes hospital, st. However, any injury that forces the end joint of a finger to overbend can cause it. The tendon is damaged, but no fractures bone cracks or breaks are present. Mallet splint is worn only at night and discontinued completely during the day if there is no extensor lag 9 weeks. Mallet finger rehabilitation protocol conservative management kelly holtkamp, m. Mallet finger also referred to as baseball finger occurs when an incident causes the extensor tendon at the tip of the finger or thumb to be stretched, cut or ruptured. The impact of cormpliance on the rehabilitation of. Mallet finger is a flexion deformity resulting from avulsion of the extensor mechanism from the dip joint synonyms for this injury are baseball finger and drop finger, and jamming injuries in ball sports are common the anatomy of the dorsal apparatus of the fingers is complex and has generated detailed descriptions. The usual cause is an injury to the end of the finger. Mallet finger occurs when the outermost end joint of the finger is injured.
Mallet finger is a deformity caused by traumatic loss of continuity between the extensor apparatus and the distal phalanx. Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb. Active pip flexion of affected finger with adjacent fingers held in extension. This can damage the tendon and bone, causing the finger to droop. Mallet finger rehabilitation protocol conservative management.
Mallet finger advice on removal of your splint your tendon is becoming stronger but it is not fully healed. Mallet tendon rupture therapy the protocol for treating mallet fingers is the same whether the patient has required open reduction and internal fixation, percutaneous pin fixation, or is being treated nonoperatively. Repeat slowly, holding for 5 seconds at the end of each. Rehabilitation after surgery for mallet finger focuses mainly on keeping the other joints mobile and preventing stiffness from disuse. Gently bend the injured finger with your other hand.
Mallet finger is a condition often seen after sports related trauma that causes the finger tip to droop, sometimes confused as a dislocation. The extension block technique for the treatment of mallet. Less often, the cause is a fracture at the bottom of the bone where the tendon attaches. The extension block technique for the treatment of mallet finger fracture. Although it is also known as baseball finger, this injury can happen to anyone when an unyielding object like a ball strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. Patient to perform daily skin check while keeping dip extended. Mallet finger is a flexion deformity of the finger that results from injury to the extensor mechanism at the base of the distal phalanx. This injury, which typically results from trauma, such as when the fingertip is hit by a ball, causes the tip of your finger to droop.
The tendon on the back of the joint snaps or pulls off its attachment to the bone. The ishiguro technique for the treatment of mallet finger. Exercises improve movement and strength of your finger after this injury. Mallet finger why is physical therapy important to your. Mallet finger therapy exercises things you didnt know.
It is often caused by catching the finger end on during sport, but it sometimes results from a minor injury such as catching the finger when tucking in bed sheets. Dip 100 hyperextension for tendinous mallet 68 weeks. Louis, missouri c ompliance has been defined as the. Then wrap the finger with clean gauze or a clean cloth. If swanneck deformity develops, reduce it passively. Splinting is the treatment of choice for almost all mallet finger injuries. Open treatment can result in frequent complications, and the surgeon should resist the temptation to make good better by operating on these injuries. You will not be able to straighten the end of your finger because the tendon connecting the muscle to the finger bone is stretched or torn. This condition is also known as baseball finger because it most often occurs when a ball or other object strikes the tip of a straight.
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