Gregory O'Toole - Hand Doctor, London

Taking off your socks, making the bed, drawing the curtains, somehow your finger gets caught and all of a sudden you can't move the tip. Or maybe you try to catch a ball which hits the end of the finger and in an instant, the last knuckle is flexed, swollen and just won't straighten. This could be a mallet finger injury.

Mallet finger is a common condition which is caused by the tendon which straightens the last knuckle no longer working. This is often because the tendon itself is torn but can also be due a fractured bone as the tendon pulls off a piece of the bone it inserts into. Whatever the cause, the result is the same. However hard you try, the finger will just not straighten !

Occasionally it's the thumb which is affected but it is much more commonly one of the fingers. Initially it will be sore, but the pain might will gradually resolve, but with the finger is still bent over it will become clear sooner or later that something isn't right.

 For the best results, treatment should be immediate, but often patients wait a few days before seeking help. Sometimes it's weeks down the line before a Hand Surgeon is consulted.

 Without treatment, the finger will stay bent and eventually will stiffen up.

 At an appointment, an X-ray will be taken to see if the bone is broken. When it isn't treatment will be with a simple, small and discrete plastic splint, made specifically for your finger by expert Hand Therapists. Even when there is a break in the bone treatment with a splint is often enough and surgery can be avoided. Only when the bone is badly broken and a large fragment has become loose, is a simple operation under local or general anaesthetic necessary, to put the pieces back together.

 A Mallet Splint is worn continuously for at least eight weeks, allowing the tendon or the bone to heal in good position. The splint can be removed so the finger can be kept clean, but it must be held straight with the other hand so that the healing process can continue. When the splint comes off, the exercises begin, under the watchful eye of the Hand Therapist, so that stiffness is prevented and finger function optimised.

 The optimal result a fully functioning finger, nice and straight and with a full range of movement, as if the injury had never happened.

London Hand and Wrist Unit


Mallet Finger