Mallet Finger
What is Mallet Finger and how is it treated?
Mallet finger (also known as “Baseball Finger”) is an injury that occurs when the extensor tendon responsible for straightening the fingertip is torn. It commonly happens when the tip of an outstretched finger is struck - such as by a ball during sports. As a result, the fingertip droops downward and the person cannot actively straighten it.
In most cases, it is treated conservatively with immobilization. However, when complications or fractures occur, surgical treatment is necessary to restore full range of motion and prevent permanent deformity.
When is surgery needed?
Surgery is indicated in cases of:
- avulsion fracture with displacement
- joint instability
- open tendon injury
- failure of conservative treatment after 6–8 weeks
What types of surgical treatment are available?
- Kirschner wire fixation (K-wires) - wires are inserted through the distal joint to fix the bone and tendon in the correct position.
- Tendon suturing - in cases of complete tendon rupture without fracture, the tendon is surgically reconstructed.
- Mini-implants or screws - sometimes used for precise fixation of bone fragments.
- Arthrodesis of the distal interphalangeal (DIP) joint - in chronic cases where function is permanently impaired and pain is present.
Surgical procedure
The operation typically lasts between 30 and 45 minutes. It is performed on an outpatient basis under local or regional anesthesia, allowing the patient to go home the same day. After surgery, a splint must be worn for another 6–8 weeks for proper immobilization.
Recovery and rehabilitation
Following surgery, immobilization with a splint is required for 6 to 8 weeks. An individually tailored rehabilitation program is strongly recommended including range-of-motion and strengthening exercises along with regular clinical check-ups with the surgeon every 2–3 weeks and follow-up X-rays. Full return of finger function is usually expected within 2–3 months.
Important: avoid forcing any movement until the surgeon approves splint removal, as premature stress can cause the injury to recur.
Possible complications
As with any surgical procedure, complications are possible but rare. These may include:
- infection
- displacement of wires or screws
- reduced range of motion
- joint stiffness (especially without proper physical therapy)
In conclusion, surgery for mallet finger is indicated when conservative treatment cannot ensure joint stability and a good functional outcome. Early recognition, timely intervention and an individualized treatment approach are key to successful recovery.
If you sustain such an injury, do not ignore it - athough it may seem “minor”, an untreated mallet finger can permanently impair finger function.
