Mallet finger Baseball finger

In the case of mallet finger, the tendon that extends the tip of the finger is ruptured, making it impossible to extend the finger actively.

The tip of the finger assumes a typical flexed position, as shown in the photograph.

The tip of the finger is able to extend thanks to the extensor tendon that is attached to the tip of the finger like a rope. When a muscle pulls on the tendon, the tip of the finger extends. If the extensor tendon ruptures, the tip of the finger is suddenly unable to extend and remains in the flexed position. Sometimes a piece of bone to which the tendon attaches will also tear off.

Mallet finger occurs when the tip of the finger is flexed forcefully. This is common in sports, such as volleyball, basketball or football (goalkeepers). The ball strikes the tip of the finger, causing it to flex in one go.

The extensor tendon can also rupture during daily activities. Classic examples include making the bed or pulling up a sock.

The diagnosis is quite straightforward for a healthcare professional to make. The presence of trauma and a characteristic position of the fingertip very clearly indicate that it is a mallet finger. When major trauma is the cause, additional tests may be necessary to investigate any other injury to the finger.

The injury is usually treated with a splint for the first six weeks. The fingertip is fixed in extended position and may not be flexed for that period. The splint must be worn continuously. If the symptoms are not resolved, or if a larger piece of the bone has torn off, the tendon can be reattached surgically.

Following splint treatment or surgery, a physiotherapist can assist in gradually building up the mobility and strength of the finger.

Peters-Veluthamaningal, C., Willems, W., Smeets, J.G.E., Windt, D.A.W.M. Van der, Spies, M.N., Strackee, S.D., Vos, K., Wind, L.A. & Geraets, J.J.X.R. (2010) NHG-Standaard. Hand- en polsklachten Huisarts Wet. 2010:53(1):22-39.