Most mallet finger injuries are treated with a splint that holds the fingertip straight (in extension) until it heals. The splint must be worn full time for six to eight weeks to restore function to the finger. If the fingertip droops, healing is disrupted, and you may not heal appropriately.  

Certified Hand Therapists can make a cast or custom orthosis to hold the tip of the finger in the correct position to heal correctly. We have devised a splint that can be worn all the time (shower, water sports, work). This makes compliance easier. Our therapists will work with patients on individualized treatment plans based on the significance of the injury. Splinting as a treatment usually results in both acceptable function and appearance. Your doctor may also schedule additional visits to monitor your progress during the healing. 

Some patients cannot splint full time for 6-8 weeks because of work (nurse, doctor, dentist, those that must wash hands aggressively) or allergic issues with the splint material. Those patients can have a pin placed across the joint to hold the finger in extension. A splint is only needed in these patients for aggressive activities and not for fine motor activities.  

Surgical repair is recommended if there is a large fracture fragment or the joint is out of line (subluxed). In these cases, surgery is done to repair the fracture using pins to hold the pieces of bone together while the injury heals. 

Mallet fingers that are chronic can sometimes be treated with surgery successfully. Most physicians will recommend fusing the end of the joint so it no longer moves. This procedure is well tolerated in the index and long finger but not as much with the ring and small.

Who Needs It

In a mallet finger, the fingertip droops, and it cannot straighten on its own. Usually, one can push the finger back up to normal alignment but are unable to hold it extended. The finger is commonly thought to be “jammed.” The finger may be painful, swollen or bruised. Often there is NO PAIN, just a drooping finger.  

The finger should be immobilized in extension. That is, place the finger in a splint and keep it there until you can see a hand specialist. If a mallet finger is not treated in the first few days, the finger may not function correctly and may cause pain.

After discussing your medical history and symptoms, your doctor will examine your finger. X-rays are needed in all cases of mallet finger to see if there is a fracture. Injuries with even a minor swelling may have a fracture. Your physician will also look for any other injuries. In select cases, our surgeons will ultrasound your finger to see if the tendon is retracted. A retracted tendon treated with surgery early can yield a superior result over non-operative treatment.