wrist/hand MALLET FINGER
DEFINITION:
- Also known as “Baseball finger”.
- A deformity to the end of the finger (distal phalanx) caused by rupture or avulsion of the extensor tendon off the distal phalanx. (See illustration).
- With an avulsion type injury, a small fragment of bone may be pulled off the distal phalanx.
MECHANISM Of INJURY / HOW IT OCCURS:
- A result of either the finger being forcefully flexed against an active contraction of the extensor tendon at the distal interphalangeal joint or a hyperextension force compressing the bones against each other.
- Injury seen in football receivers, baseball fielders, and basketball players.
SYMPTOMS:
- Individuals complain of pain to the end of the finger.
- An inability to extend (straighten) the end of the finger.
DIAGNOSIS:
- Physical examination reveals a flexed finger which can be passively extended but not actively.
- Tenderness around end of finger.
- Swelling.
- Radiographs are helpful to detect an avulsion of bone off the distal phalanx.
TREATMENT/REHABILITATION:
- The initial treatment is to splint the finger in extension for 6 weeks continuously, either with a volar (front) splint or a dorsal (back) splint.
- After 6 weeks a gradual exercise program is started with continued splinting during sporting activities for an additional 6 weeks.
- Consider surgery if deformity persists.