Mallet Finger

Aeitiology

  1. Damage / division of extensor tendon to the terminal phalanx of finger involved
  2. May occur if flake of bone avulsed from the base of the distal phalanx ("baseball finger") 

 

Approach

  • As for any hand examination
  • Place palm upwards
  1. Look

    • Flexion deformity of distal phalanx of one or more fingers
  2. Feel
  3. Move
    • Active movement of finger - terminal phalanx cannot be actively extended
    • Passive movement - digit can be moved back into normal position (unless chronic)

Management

  1. X-ray to exclude fracture
  2. Splint finger for 6 weeks (in a mallet splint) to allow reattachment of tendon
  3. If avulsed flake of bone greater than 1/3 width of joint space on the lateral x-ray it should be repositioned with Kirschner wire or other internal fixation device