Gaps in practice

January/February 2011

Mallet finger

Management and patient compliance

Volume 40, No.1, January/February 2011 Pages 47-48

Daniel Anderson

Background

Mallet finger is a flexion deformity of the finger resulting from injury to the extensor mechanism at the base of the distal phalanx.

Objective/s

This article discusses the current clinical assessment and appropriate management of mallet finger injuries.

Discussion

Mallet finger usually results from forced flexion of an extended finger. Treatment can be difficult as patient compliance is essential, and if not treated appropriately the injury can lead to permanent deformity. Patients will present with a flexion deformity of, and inability to actively extend, the distal interphalangeal joint. Closed mallet finger injuries are managed in a strict extension or hyperextension immobilisation splint for 8 weeks. Surgery is reserved for injuries involving fracture to greater than 30% of the articular surface, volar subluxation of the distal phalanx, avulsed fragments that fail reduction, injuries failing conservative management, and absence of full passive extension of the joint. Early referral is recommended if there is any concern.

Mallet finger is a flexion deformity of the finger that results from injury to the extensor mechanism at the base of the distal phalanx. It can involve either a bony avulsion injury of the distal phalanx or a rupture of the extensor tendon with no bony involvement (Figure 1).1 Other terms used are ‘baseball finger’ and ‘drop finger’.2 The injury usually results from a blow causing forced flexion of an extended finger.1 This is a difficult injury to treat, and if not treated appropriately can lead to permanent deformity.

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Correspondence afp@racgp.org.au

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