Mallet Finger

Mallet finger, also known as baseball finger, is a common injury affecting the distal phalanx, the joint at the tip of the finger. This condition arises when the extensor tendon, responsible for straightening the finger, is damaged. The damage leads to the inability to extend the tip of the finger, causing it to droop downwards, resembling a mallet.

The injury is typically the result of a sudden force striking the tip of the finger or thumb, bending it further than its normal range of motion. While often associated with sports, a mallet finger can also occur from everyday activities involving a forceful impact on the finger.

Here are the common scenarios leading to a mallet finger:

• Sports Injuries
  Sports that involve balls, such as basketball, baseball, cricket, or volleyball, are frequent contributors to mallet finger injuries. The sudden impact of a ball hitting the tip of the finger can cause the tendon to rupture or pull away from its attachment to the bone.
• Domestic Accidents
  Simple household accidents, such as tucking in a bedsheet forcefully or catching a finger in a door, can also lead to a mallet finger. These incidents may seem minor but can significantly impact the tendon’s integrity.
• Occupational Hazards
  Certain occupations that involve manual labour or the risk of finger impacts can predispose people to mallet finger. This includes construction work, mechanical jobs, and culinary professions where handling heavy or unwieldy objects is common.
• Direct Trauma
  Directly hitting the finger against a hard surface or object can cause a mallet finger, especially if the force is directed downward on the fingertip.

Mallet finger presents with distinct symptoms that are primarily focused on the affected finger’s appearance and functionality.

• Drooping of the Finger Tip
  The most characteristic symptom is where the tip of the finger or thumb bends downwards at the distal joint and cannot be straightened voluntarily.
• Pain and Swelling
  Shortly after the injury, the affected finger may become painful and swollen, especially at the distal joint. The intensity of pain can vary depending on the severity of the tendon damage.
• Bruising
  In some cases, bruising may appear around the back of the finger due to the trauma.
• Tenderness
  The injured area may feel tender to the touch, indicating inflammation and sensitivity.
• Stiffness
  The affected finger may become stiff over time, especially if the injury is not treated promptly.
• Limited Movement
  Disrupting the function of the extensor tendon may reduce the finger’s ability to move, particularly when extending it.

Surgical intervention for a mallet finger may be considered in specific circumstances, such as when the injury involves a large fracture fragment or when a joint misalignment cannot be corrected with non-surgical methods. The following outlines the primary surgical options and considerations for mallet finger:

• Tendon Repair
  In cases where the tendon has been significantly damaged or severed, surgery may involve stitching the torn ends of the tendon together. This is often accompanied by the placement of a temporary pin or wire to hold the finger in extension until the tendon has healed.
• Fracture Fixation
  Surgical fixation might be necessary if the injury includes a fracture where a piece of bone has been pulled off with the tendon. This can involve pins, screws, or wires to secure the bone fragment in its proper position, allowing the tendon and bone to heal correctly.
• Joint Realignment
  In some instances, surgery may be required to correct misalignment within the joint. This could involve repositioning bone fragments or adjusting the tendon attachment to improve the finger’s alignment and function.