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 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.
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