Mallet Fingers

What is a mallet finger?

A mallet finger is caused by rupture of the tendon to the tip of the finger. Sometimes, the tendon may pull off its bony attachment. As a result, you are unable to straighten your finger tip on its own, although it can be pushed straight. Unsupported, the finger tip will have a characteristic ‘droop’. In most cases, it is not painful, but more of a nuisance.

Sometimes if the mallet finger has been caused by a sports injury, the end of your finger may well be painful, red and swollen.

How is the mallet finger treated?

Your finger is placed in a special plastic splint holding the tip straight for 6 - 8 weeks. During this time, the finger tip must be kept straight at all times, so healing can take place. It is essential that you carefully follow the instructions given to allow healing.

Your splint

• Your splint should be a comfortable fit, not too tight or loose. If it becomes loose, then you should return to us for a better fitting splint.
• The splint holds the tip joint straight, but should allow full movement of the middle joint of the finger to avoid it stiffening.
• You must ensure that the finger stays dry within the splint, which is not an easy task! Use a large protective rubber glove. Should your finger get wet inside the splint, then you will need to remove the splint and dry it and your finger.
• Each time you remove the splint you increase the risk of bending your finger and re-damaging the healing tendon. So, only remove it when absolutely necessary like when the finger and splint need cleaning or if they get wet.

When removing the splint

It is essential to follow the instructions below and it is helpful if you have someone else around when you do it.

• First, place your hand on a flat, firm surface i.e. a table.
• Loosen the tape and gently remove the splint keeping your finger flat on the table.
• Wash the top and sides of your finger with soap and water. To get underneath you can lift the finger up on its tip (maintaining the straight position).
• Dry the finger thoroughly.
• The splint will also need cleaning, but it is easier if someone does this for you.
• Carefully slide the splint back into place without allowing any bend, re-tape and secure. Make sure that the tape does not restrict the movement of the middle joint of the finger.

You will soon get used to this routine and it should be followed for the full 8 weeks.

After the 8 week

You will re-attend and be given further guidance and instructions. The splint will be removed leaving a stiff, but straighter fingertip. In some cases, the healed finger will have a residual ‘droop’ to the tip.

It may take several months for your finger to fully recover its function. Any redness, swelling and tenderness of your skin over the end of your finger may persist for the first few months after the injury. These symptoms will usually improve.

In summary

• Keep your splint on.
• Keep your fingertip straight.
• Keep it dry.

© North Bristol NHS Trust. This edition published April 2024. Review due April 2027. NBT002261.