• +27 (0)21 879 4264
  • info@assicfitness.com
  • My account
  • Cart

  • Home
  • Applications
    • Resting Heart Rate
    • Recovery Heart Rate
    • Fitness
    • Performance Fingerprint
    • Strength and Conditioning
  • Health Professionals
    • Find your Professional
    • Book a Professional
  • Education
    • Know your Body
      • Body profile
      • Cardiac
      • Exercise/Rehab Routines
      • Fitness
      • Fluid Balance
      • Muscle
      • Bone/Tendon/Joint
      • My Surgery
      • Yoga
      • Nutrition
    • Blog
      • Articles
      • Monthly Routines
      • News and Opinion Pieces
    • COVID-19
      • What You Need to Know
      • Overview of COVID-19
      • COVID-19 Map
    • How to Use the Apps
      • Performance Fingerprint
      • COVID-19 Vitals
      • Connecting Professionals
    • Biomarkers
      • COVID-19
      • Infection/Inflammation
      • Endurance
      • Hydration
      • Performance Fatigue
      • Metabolism
      • Muscle Cramps
      • Nutrition
    • Medical
      • Hip
      • Knee
      • Ankle/Foot
      • Shoulder
      • Elbow
      • Wrist/Hand
      • Back
  • Health Calculators
  • About
    • Contributors
      • Become a Contributor
    • Partners
      • Lancet Laboratories
    • Professionals
    • Press
    • Professional Dual View Access Application
  • Contact
✕

Mallet Finger

Categories
  • Hand
  • Joint/Tendon
Tags
  • Hand injury
Hand

Mallet Finger

Muscles of the Forearm
Muscles of the Forearm
Extensor muscles
Carpal Tunnel Syndrome
Dorsal view left hand

Dorsal view left hand

Volar view left hand

Volar view left hand

Mallet Finger (Baseball finger)

Mallet finger is a common sports injury and occurs when the distal end of the extensor tendon (Extensor digitorum or Extensor pollicis longus of thumb) is torn, thereby causing an inability to straighten the distal end of finger.

Baseball finger

Injury Mechanism:

  • Direct force to finger with forceful flexion to an extended finger

Causes:

  • Impaction to finger
  • Laceration to extensor side of finger

Presentation:

  • Pain
  • Deformity with distal phalanx in flexion position with inability to extend distal finger

Clinically:

  • Flexion of distal interphalangeal (DIP) joint
  • Inability to extend DIP joint
Mallet finger

Mallet finger

Doyle’s Classification of Mallet Finger

Doyle’s classification of Mallet finger

Type Ⅰ: Closed injury ± small dorsal avulsion fragment
Type Ⅱ: Open injury
Type Ⅲ: Open injury with loss of skin and tendon
Type Ⅳ: Mallet fracture
A: distal phalanx physis injury (Paediatric injury)
B: Fracture fragment with 20-50% articular surface involved
C: Fracture fragment > 50 % articular involved

Management

Investigation:

X-rays:
  • Assess proximal bone fragment fracture of the distal phalanx and the articular size (> 40% significant) and if > 2 mm displaced
  • CT: Useful for evaluation of fragment

Management:

Nonoperative:
  • Keep distal DIP joint in extension using an extension splint (Mallet splint) for 6-8 weeks
Surgery:
  • > 40 % articular surface, displaced (>2mm) fragment and volar subluxation of distal phalanx or incongruent joint with subluxation
Surgery options:
  • Acute tendon repair
  • Acute bone fragment ORIF with pin or screw fixation
  • Chronic tear: Swan neck correction with lateral band/FDS tenodesis, Fowler central slip tenotomy
  • DIP joint arthrodesis
Mallet splint

Mallet splint

Mallet finger screw fixation

Mallet finger screw fixation

Mallet finger K-wire fixation

Mallet finger K-wire fixation

Surgery Technique

Surgery

Mallet Reduction Using K-wire as an Extension Block

Mallet reduction using K-wire as an extension block

Small dorsal insertion at entry point of K-wire using X-rays

Insert K-wire at 45° angle and engage distal cortex

Reduce fracture by extension of distal phalanx

Maintain position with additional K-wire or splint

Mallet K-wire fixation

Mallet K-wire fixation

X-ray guidance

Make small dorsal incision at entry point of dorsal K-wire

Use second K-wire parallel to distal phalanx and use as joystick to reduce fracture

Advance dorsal K-wire

Mallet finger ORIF screw fixation

Mallet finger ORIF screw fixation

Approach: Dorsal

Reduction and fixation with 1-1.3 mm screw fixation

Rehabilitation

  • Mallet splint for 8 weeks
  • Range of motion hand digital exercises
  • Strengthening fingers after union
  • Return to sport after 3 months
Active wrist ROM after 2 weeks

Active wrist ROM after 2 weeks

Finger adduction strengthening

Finger adduction strengthening

Resisted finger extension

Finger abduction strengthening

Hand squeeze

Hand grip strengthening

Download ASSIC performance fingerprint or ASSIC strength & conditioning aps for rehabilitation guideline routines or create own routine under professional guidance

apple app store  google play store

References

  1. Current concepts: mallet finger. SR Alla, ND Deal, IJ Dempsey. Hand (NY). 2014 Jun;9(2): 138-44.
  2. The diagnosis and management of Mallet finger injuries. GA Lamaris, MK Matthew. Hand (NY). 2017 May;12(3): 223-228.
  3. Surgical and nonsurgical management of Mallet finger: A systematic review. JS Lin, JB Samora. J Hand Surg Am. 2018 Feb;43(2): 146-163.

Related posts

Ankle
Jun 17, 2022

Posterior Tibial Tendon Dysfunction Syndrome


Read more
Shoulder
Jun 13, 2022

Acromioclavicular Joint Subluxation


Read more
Ankle
Jun 10, 2022

Sever’s Disease


Read more
Hand
Jun 10, 2022

Intersection syndrome


Read more
assic fitness and health white logo

ASSIC is a pioneering technology based Sports Science Company designing tools to assist in personal fitness management for individuals and professional athletes.

Education

  • Home
  • Applications
  • Health Professionals
  • Education
  • Health Calculators
  • About
  • Contact

Our Applications

  • Resting Heart Rate
  • Recovery Heart Rate
  • Fitness
  • Strength and Conditioning
  • Performance Fingerprint
  • Medical Examination

Download our Applications

apple app store
google play store
© 2022 ASSIC Medical (PTY) Ltd. All Rights Reserved. Created and Hosted by: Lava Lamp Lab
0

R0.00

  • My account
  • Cart
✕

Login

Lost your password?

Create an account?

Change Location
Find awesome listings near you!