Mallet Finger

A dropped fingertip after an injury. Usually treated with a splint worn continuously for 6 to 8 weeks.

Finger with a mallet deformity, the fingertip drooping and unable to straighten — The classic look of a mallet finger: the fingertip droops and cannot be actively straightened.

What is mallet finger?

A small tendon on the back of your finger straightens the fingertip. A sudden bending force (such as a ball striking the tip, or catching a finger on furniture) can tear that tendon or pull off a small piece of bone with it. The fingertip then droops and you cannot lift it on your own. This is called a mallet finger.

Illustration of the extensor tendon pulled away from the distal phalanx at the tip of the finger — The extensor tendon tears away from the bone at the tip of the finger, so the fingertip can no longer lift.

Common symptoms

The tip of the finger droops and you cannot straighten it by itself
You can still bend the tip; what you cannot do is straighten it
Pain and swelling over the back of the last finger joint
A bruise or tenderness along the top of the fingertip

Why does it happen?

Mallet finger is usually caused by a ball striking the end of an extended finger (basketball, volleyball, baseball) or by catching the finger while tucking in a bedsheet or reaching into a bag. It can also happen with a small cut over the back of the fingertip.

Treatment options

Non-surgical treatment

Continuous splinting. A small splint holds the fingertip straight 24 hours a day for 6 to 8 weeks. Letting the fingertip bend even once during that time can restart the healing clock, so the splint is only removed for careful skin care with the finger kept flat on a table. This works for the majority of mallet fingers.

Fingertip held in a small splint that keeps the tip straight — A small splint holds the fingertip straight for 6 to 8 weeks. The finger can never be allowed to droop during that time.

Surgical treatment

Pinning or repair. Surgery is only needed for some mallet injuries, usually when a large piece of bone has been pulled off, when the joint is dislocated, or when splinting has failed. A small pin across the joint holds the finger straight while it heals.

X-ray of a mallet finger stabilized with a single small pin crossing the end joint — For certain mallet injuries, a temporary pin holds the fingertip straight while the tendon or bone heals.

What to expect at your visit

Dr. Barrera will examine the finger and take an X-ray to see whether a piece of bone has come off with the tendon. In most cases a splint can be fitted the same day. You will be shown how to care for the skin without letting the fingertip bend, which is the key to a good outcome.

X-ray of a finger with a small bone fragment pulled off the back of the distal phalanx, a bony mallet injury — On X-ray, a small piece of bone is sometimes pulled off with the tendon. This is called a bony mallet.

When to call the office sooner

Call us right away if there is a cut or broken skin over the dropped fingertip, if the finger becomes red and warm (signs of infection), or if the fingertip looks pale or cold.

Questions?

Call your office location for non-urgent questions:

NYU Langone Laurelton · 646-501-4950
NYU Orthopedic, Woodside · 929-429-3222
NYU Orthopedic, Richmond Hill · 718-206-6923
Jamaica Hospital Ambulatory Care Center (ACC) · 718-301-0720

See our office contact information for addresses and fax numbers.