Mallet Finger






-  Injury of extensor digitorum tendon at distal interphallangeal joint +/- fracture of distal phallange



-  Patients often present month post injury

-  Most common closed tendon injury in atheletes



-  Forcible flexion (hyperflexion) of extended DIP

-  Finger jammed by ball (basketball..)


Associated S/S

-  Sustained flexion at DIP joint: unopposed flexion of flexor digitorum profundus (FDP)

-  Inability to extend DIP joint

-  Swan neck deformity may develop from tendon pull imbalance (hyperextension)




-  Hand exam

-  X-ray

-  +/- fracture of dorsal base of distal phallange




-  Splint

-  Mallet splint (DIP splint) 6-10 weeks

-  PIP joint NOT immobilised

-  Avoid flexion (at any time) for 6 weeks then R/V

-   If extensor lag present splint up to 10 weeks

-   If not then night splint 2-3 weeks

-  Poor response if Swan neck deformity

-  K-wire

-  Indicted if

-   Volar subluxation w >30% joint surface involvement

-   Open fracture

-  6 weeks then night splint 4 weeks

-  Direct repair

-  Tendon repair

-  +/- K-wire







Wheeless Textbook of Orthopaedics: _finger

Pic (Splint):

Pic (finger):

Pic (x-ray):