What Is Mallet Finger?
A mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb. If left untreated, mallet finger can cause permanent drooping, stiffness and deformity of the fingertip.
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What Causes Mallet Finger?
Mallet finger results from injury to the extensor tendon, which straightens the last joint of the finger. There are two main types:
- Tendon rupture: The tendon tears from sudden force, like jamming the finger or cutting it. It may also happen slowly over time due to arthritis.
- Bony mallet finger: A small piece of bone at the tendon’s attachment site breaks off, preventing the tendon from moving the fingertip.
Common causes include sports injuries, forceful bending of the fingertip during activities like lifting heavy objects or scrubbing, and deep cuts or lacerations to the back of the finger.
Signs and Symptoms of Mallet Finger
You may have a mallet finger if you notice:
- Pain, swelling, or bruising at the fingertip
- Drooping of the fingertip that cannot straighten on its own
- A bump just below the fingernail
- Blood under the nail or nail detachment (in severe injuries)
Sometimes, mild drooping can appear naturally due to tissue flexibility, but trauma is the most common cause.
Mallet Finger Treatment
Most mallet finger injuries can be treated without surgery.
- Splinting: The fingertip is held straight in a splint for 6–8 weeks. Even brief bending can disrupt healing, so careful adherence is essential.
- RICE: Following the protocol for rest, ice, compression and elevation can help reduce swelling.
- Hand therapy: Exercises for the middle joint maintain mobility while the end joint heals.
After the tendon or bone heals, the splint may be worn only during sleep or sports for a few additional weeks to prevent re-injury. Slight droop or minor contour changes may remain even after successful treatment.
Surgery for Mallet Finger
Surgery may be necessary if there is a large bone fragment, a misaligned joint or splinting is unfeasible and/or has failed. Surgical options can include:
- Realigning the joint with wires or screws
- Repairing or reconstructing the tendon
- Fusing the joint to keep it straight
How Long Does Mallet Finger Take to Heal?
With proper treatment, most people regain good function and appearance of the fingertip. Recovery may take several weeks to months, and exercises are often required to restore motion. Early intervention significantly improves outcomes and reduces the risk of permanent deformity.
Treat Mallet Finger at OrthoNebraska
Need help with mallet finger in the Omaha area? At OrthoNebraska, we want to make sure that our patients feel understood, safe and confident to take on an appropriate treatment plan. With proper management, we can help you reduce pain levels and improve quality of life.
