Discharge advice following Mallet Finger injury

Information for patients

NHS Lanarkshire Emergency Department

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What is a Mallet Finger injury?

A Mallet finger injury can occur in a number of ways, but most commonly when a straight finger is stubbed and forced to bend suddenly at the joint near the finger tip.

The tendon on the back of the joint snaps or pulls off its attachment to the bone. An x-ray will determine whether you have injured the tendon or have a fracture (break). As a result you can no longer straighten the finger at this joint except by lifting it with the other hand. The tip of the finger adopts a dropped position.

What is the treatment?

A splint will be applied and should be worn continuously, even at night, to keep the tip

of the finger straight for 6 weeks or longer depending on your injury. A bony mallet injury will need 6 weeks of continuous splinting and a tendon mallet injury will need 8 weeks of continuous splinting. It takes this length of time for either the bone or tendon to heal. If you remove the splint at any point in this time period then the tip of the finger will drop again and it will remain in the dropped position.

Treatment is most likely to succeed if the splint is always taped securely in place and worn constantly.

Illustration of mallet finger, and a torn tendon in the finger.

To wash the finger:

Gently rest the tip, palm side down, on the edge of a table or similar surface.
Remove the tape and carefully slide the splint off. Keep the tip of the finger on the table and keep the joint straight all the time you are doing this.

Illustration of a finger rested on a table.

Wash the skin and dry it thoroughly before re-applying the splint.
Replace the splint without bending finger.
Secure the splint with fresh tape.

Try to limit washing the finger to reduce the chance of the finger bending. Initially aim for cleaning the finger twice a week.

It is important to keep the finger and splint dry to avoid skin irritation.

What happens when I remove the splint?

It is important that the middle joint of your finger is free to move to prevent stiffness See figure 2. If the splint is blocking this joint let a member of staff know. Remember to move the rest of your finger. Only the tip needs to be kept straight.

When you remove the splint after 6 or 8 weeks, your finger may not bend easily at the joint which has been splinted, this will wear off in a few days.

After the initial period of wearing the splint continuously you should continue to wear it for a further 2 weeks at night, with gentle exercise and whenever the finger might be at risk of injury.

After the splint has stopped being used completely after a further 4 weeks, it is important to keep gently moving the finger and gradually resume daily activities, within the limits of discomfort.

You may be left with a small bump or there may be redness, swelling and slight pain over the joint for a few months afterwards. This will settle.

Often the finger can drop a little after the splint is removed. Most fingers function well despite a drop and in most cases it slowly improves over the next year or so.

Try to use your hand normally in your light daily activities e.g. holding newspaper/cup/washing and dressing and preparing meals (1-2kg weight) but avoid heavy gripping for up to three months until the tendon is strong.

Most injuries heal without any problems, however it may take several months to regain full function.

Where can I get advice?

You can contact us if you find:

The splint becomes too tight.
You develop sores in the skin under the splint.
Your finger drops VERY BADLY when you remove the splint at the end of the initial 6 – 8 weeks weeks.
You have any worries or concerns following discharge from hospital.

If you have any concerns on removal of your splint please get in touch with your local Hand Therapy Department, see numbers below. Only patients who have previously been treated for this injury at the Emergency Department will be able to refer in.

University Hospital Monklands: 01698 752088

University Hospital Hairmyres: 01355 585429