Mallet finger – for many it might sound like a delicious recipe, similar to Fish finger, potato fingers etc., but alas! No. Mallet finger is a deformity of the finger that is caused due to hard injury that hits the tip of the finger and damages certain tendons in the finger joint at the base of the nail or there can be a small fracture in the finger bone, both resulting in curved finger that is difficult to straightened. The damage can be at two levels either at the tendon or in the bones. If the condition is due to damaged tendon, then it is called as tendinous mallet finger and if the problem is in the bone then it is called as mallet fracture or bony mallet finger. The damage usually happens at the distal part of the finger, the part closer to the nail. It is a common sport’s injury. It is also called as baseball finger.
Causes
Stubbing of finger-tip is very common and unavoidable injury in sports like cricket, basketball, volley ball, and football. This can result in Mallet finger, the inability to straighten the finger that is caused due to injury to the extensor tendons when a ball or any other hard object hit the tip of the finger. The force of hit damages the small tendons that help to keep the finger straight. The hit may also fracture the finger bone and pull away small piece of bone along with the tendon.
Symptoms
Mallet finger manifests as swollen, painful, and bruised finger. The person may not be able to straighten the tip of the finger, and there would be obvious drooping of the finger tip. In rare cases, rarely blood clot beneath the nail. The nail could detach from the skin beneath.
Diagnosis
If a finger injury is painful, swollen, and makes it difficult to straighten the finger, the person should contact a doctor right away. Diagnosis is done by physical examination that includes looking for pain, swelling, and inability to straighten the finger. Along with physical examination, the doctor might also consider taking an X-ray to look for bone fracture.
Treatment
In many cases, non-surgical treatment options like applying ice and elevating the finger above the heart should be done immediately. Any blood clot noticed beneath the nail or detachment of nail should be dealt immediately as this may be due to open fracture. Doctor may also apply splint to hold the finger straight. The splint should be worn continuously for the next 8 weeks and after that it can be worn less frequently. Care should be taken that the end joint does not bend during splintage treatment. In many the finger usually regains its function and appearance but in some there is no obvious straightening of the finger tip. When non-surgical treatment fails and when there is a major fracture in the bone then surgical options may be considered. Surgery involves repairing the fracture using pins, wires, and screws. Surgical option is considered only if the person has severe deformity and faces problem performing daily activity. In case of tendon damage surgery is done to stretch the tendon using tendon graft and fusing the broken joint to straighten it.
Prognosis
The outcome of treatment is usually very effective in restoring the normal function of the finger. In many, there may be a slight difficulty in gaining complete straightening, it may take several months to get back satisfactory results. The outcome is very effective provided the patient doesn’t have any other complicating factors like laceration (a tear in flesh producing wound with irregular edges) and deep abrasion in the skin and tendon. Patients without these complicating factors had surprisingly very good results without any treatment. Even after complete recovery mallet finger might leave a small bump on the affected joint, which usually doesn’t pain and the finger functions properly without any difficulty.
Going back to field
The goal of treatment is to help the person to resume his play as soon and as safely as possible. The rate of recovery differs in every one; doctor will be the right person to tell the appropriate time to play again. Early activity can worsen the injury more and might result in permanent damage. Wearing a splint, as per doctor’s advice, can help faster recovery.
Conclusion
Mallet finger is not a serious illness or disease it’s just a deformity of the finger. In many, mallet finger do not cause any obvious difficulty in daily activity, but treatment should be sought because if left untreated it can result in permanent damage.
