Mallet finger
Updates to Article Attributes
Mallet finger describes a type of injury where there is disruption of the extensor mechanism of the finger at the distal interphalangeal joint (DIP). It is the most prevalent finger tendon injury in sport. This can either refer to bony avulsion injury or just tendinous injury.
Clinical presentation
A high proportion of mallet injuries will present as isolated tendon injuries with any associated avulsions fractures known as a mallet fracture 5.
It is characterised by an inability to extend the finger at the distal interphalangeal (DIP) joint. There is slight flexion at this joint.
It classically occurs sports where the DIP undergoes sudden flexion (extended finger is struck at the tip by an object, e.g. baseball) or a crush injury (slamming a door towards the distal interphalangeal joint) in the extensor direction.
Radiographic features
Plain radiograph
If there is a bony avulsion, a plain film will classically show a triangular avulsion fragment at the extensor aspect of the distal phalanx at the DIP joint.
Ultrasound
The findings on ultrasound include 6:
- loss of real-time movement of the tendon
- complete or partial extensor tendon tears
- fluid in the region of the extensor tendon insertion
- avulsion fracture
Complications
- untreated mallet fingers may progress to a swan neck deformity that will require surgical intervention 3-4
- development of secondary osteoarthritic changes 4
Treatment
Mallet injuries are predominantly conservatively treated via a splint maintaining the DIP joint in fixed hyperextension. It is very rare for any mallet finger injuries to require surgical intervention 5.
See also
- Jersey finger: disruption to flexor mechanism
-<p><strong>Mallet finger</strong> describes a type of injury where there is disruption of the extensor mechanism of the finger at the <a href="/articles/distal-interphalangeal-joint">distal interphalangeal joint</a> (DIP). It is the most prevalent finger tendon injury in sport. This can either refer to bony avulsion injury or just tendinous injury. </p><h4>Clinical presentation</h4><p>A high proportion of mallet injuries will present as isolated tendon injuries with any associated avulsions fractures known as a mallet fracture <sup>5</sup>.</p><p>It is characterised by an inability to extend the finger at the distal interphalangeal (DIP) joint. There is slight flexion at this joint.</p><p>It classically occurs sports where the DIP undergoes sudden flexion (extended finger is struck at the tip by an object, e.g. baseball) or a crush injury (slamming a door towards the distal interphalangeal joint) in the extensor direction.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>If there is a bony avulsion, a plain film will classically show a triangular avulsion fragment at the extensor aspect of the distal phalanx at the DIP joint.</p><h4>Complications</h4><ul>- +<p><strong>Mallet finger</strong> describes a type of injury where there is disruption of the extensor mechanism of the finger at the <a href="/articles/distal-interphalangeal-joint">distal interphalangeal joint</a> (DIP). It is the most prevalent finger tendon injury in sport. This can either refer to bony avulsion injury or just tendinous injury. </p><h4>Clinical presentation</h4><p>A high proportion of mallet injuries will present as isolated tendon injuries with any associated avulsions fractures known as a mallet fracture <sup>5</sup>.</p><p>It is characterised by an inability to extend the finger at the distal interphalangeal (DIP) joint. There is slight flexion at this joint.</p><p>It classically occurs sports where the DIP undergoes sudden flexion (extended finger is struck at the tip by an object, e.g. baseball) or a crush injury (slamming a door towards the distal interphalangeal joint) in the extensor direction.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>If there is a bony avulsion, a plain film will classically show a triangular avulsion fragment at the extensor aspect of the distal phalanx at the DIP joint.</p><h5>Ultrasound</h5><p>The findings on ultrasound include<sup> 6</sup>:</p><ul>
- +<li>loss of real-time movement of the tendon</li>
- +<li>complete or partial extensor tendon tears</li>
- +<li>fluid in the region of the extensor tendon insertion</li>
- +<li>avulsion fracture</li>
- +</ul><h4>Complications</h4><ul>
References changed:
- 6. Kleinbaum Y, Heyman Z, Ganel A et-al. Sonographic imaging of mallet finger. Ultraschall Med. 2005;26 (03): 223-6. <a href="http://dx.doi.org/10.1055/s-2005-858165">doi:10.1055/s-2005-858165</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/15948059">Pubmed citation</a><span class="auto"></span>
Unable to process the form. Check for errors and try again.