Mallet Finger (Baseball Finger)

Overview

Mallet finger, also known as baseball finger, is an injury to the thin tendon that straightens the end joint of a finger or thumb. It occurs when the tendon is damaged or torn, often as a result of an impact to the fingertip. This injury prevents the finger from straightening at the distal interphalangeal (DIP) joint, causing it to droop.

Causes

Mallet finger typically results from:

• Trauma: A direct blow to the tip of the finger, such as when a ball strikes an outstretched finger during sports.
• Accidental Injury: Catching a finger on an object, forcefully bending it.
• Lacerations: Cuts that sever the tendon.

Symptoms

Symptoms of mallet finger include:

• Pain and Swelling: Immediate pain and swelling at the fingertip.
• Inability to Straighten the Finger: The affected finger cannot be actively straightened at the DIP joint.
• Drooping of the Finger: The fingertip droops noticeably, even when trying to extend the finger.
• Bruising: Bruising around the fingertip.

Diagnosis

Diagnosis involves a combination of clinical examination and imaging studies:

• Medical History and Physical Examination: Assessment of symptoms, injury history, and physical examination to check for deformity, tenderness, and inability to extend the finger.
• X-rays: Used to determine if there is an associated fracture at the distal phalanx or to assess the extent of the injury.

Treatment

Treatment for mallet finger depends on the severity of the injury and may include:

• Non-Surgical Treatment:

  • Splinting: The primary treatment involves splinting the affected finger in an extended position for 6-8 weeks. The splint must be worn continuously to allow the tendon to heal properly. After the initial period, the splint may be worn at night for an additional few weeks.
  • Pain Management: Over-the-counter pain relievers, such as ibuprofen or acetaminophen, to manage pain and swelling.
  • Follow-Up Care: Regular follow-up visits to ensure proper healing and to adjust the splint as needed.

• Surgical Treatment:

  • Surgery may be considered for severe cases, such as when there is a large fracture fragment, joint misalignment, or if non-surgical treatment fails to restore function. Surgical options include:
    • Tendon Repair: Direct repair of the tendon.
    • Pinning or Screws: Stabilizing the bone fragments if a fracture is present.
    • Tendon Grafting: Using a graft to repair the tendon if there is significant damage.

Prognosis

The prognosis for mallet finger is generally good, especially with timely and appropriate treatment. Most individuals regain full function and appearance of the finger with non-surgical treatment. However, some residual drooping or stiffness may occur in severe cases or if treatment is delayed.

Prevention

Preventing mallet finger involves taking measures to protect the fingers from injury:

• Protective Gear: Wearing appropriate protective equipment during sports and activities that pose a risk of finger injuries.
• Proper Techniques: Using proper techniques and caution when handling objects or participating in activities that can cause finger injuries.

Conclusion

Mallet finger is a common injury that affects the ability to straighten the fingertip. Early diagnosis and appropriate treatment are crucial for optimal recovery and function. If you experience a finger injury that results in pain, swelling, and inability to straighten the fingertip, seek medical attention for a thorough evaluation and personalized treatment plan. With proper care, most individuals can achieve a good outcome and return to normal activities.