Sometimes the smallest injury that looks so simple, is the most frustrating. You might be thinking “why is it even a problem”? In terms of bodily functions and appearance, a mallet finger is one of the conditions that we may consider small yet disconcerting. In this post, our resident Miami Occupational Therapist/Certified Hand Therapist discusses what a mallet finger is and what we can do for patients who have it.
What Is Mallet Finger and How Is It Diagnosed?
A mallet finger is an injury wherein the tip of the finger or thumb can no longer straighten by itself. It usually happens when you jam a finger into an object forcefully such as when catching a ball or catching your finger on something.
The force of the hit ruptures the terminal extensor tendon, which is responsible for straightening the tip of finger. As a result, the finger droops and is unable to straighten by itself. At times, the force is so hard that a small piece of bone is broken off.
X-rays are usually taken to see if there are any fractures or nonalignment. Worst case, if left untreated, you can develop a swan neck deformity, causing you to lose functional use of your finger/hand and have a lot of pain.
Furthermore, if there is a sign of bleeding beneath the nail or if the nail itself is detached, you may be at risk for infection. This is why it’s crucial to get timely and proper diagnosis. Seeking mallet finger occupational therapy will also keep the condition from worsening.
What Are the Symptoms of Mallet Finger Injury?
The result and primary symptoms of a mallet finger after injury are the following:
- Pain and swelling at the tip of the finger
- Bruising in the affected finger
- Fingertip that droops noticeably and will only straighten if pushed up by the other hand
What Are the Treatment Options for Mallet Finger?
The general protocol for conservative treatment of a mallet finger is to splint the tip of the finger straight for approximately 6 to 8 weeks and then start to move it as long as it is stiff and does not droop. Sounds easy right? It should be….but it is NOT always, which is why you need to seek a specialist for mallet finger recovery in Miami.
Non-Surgical Treatment for Mallet Finger
To treat mallet finger, different types of splints may be used. Options consist of aluminum splints taped on, stack splints, or a custom-fitted orthosis fitted. THE most important thing is to ONLY splint the small knuckle (DIP) allowing the other knuckles to move. The other MOST important aspect of treating mallet fingers is to educate you, the patient, that the tip of the finger is to remain STRAIGHT for the entire 6 to 8 weeks without falling down. Otherwise, the stiffening/healing process will be interrupted.
Surgical Treatment for Mallet Finger
There may be instances when surgery is needed to repair the finger after a mallet finger injury. An orthopedic doctor may require surgery if there is significant fracture or if the joint itself is out of line or subluxed. The surgery will be done to repair the fracture, using pins to hold the bone pieces together until they completely heal.
A Hands on Therapy Experience: A Miami Mallet Finger Case
I decided to write about mallet fingers because I recently got a new case. She came to me for mallet finger treatment in Miami after injuring her hand 6 weeks ago when she went to catch an object that was falling and jammed her finger. Immediately she could see that her finger drooped and she had a lot of pain and swelling. In the urgent care center, X-rays determined that she had no fractures. She was fitted with a stack splint to wear.
When she came to me, she had the stack splint on with the splint taped to her finger at the middle knuckle (PIP) and coban wrap that covered the length of her finger. She could not bend her finger at all, but her little knuckle (DIP) was drooped down to 30 degrees. I don’t know what happened before she came to me, all I know is that both of the most important treatment elements were not met for whatever reasons.
How We Handled Our Patient’s Mallet Finger Case
Here’s what we started to do. We need to stretch and get that DIP knuckle straight as well as massaging the finger to help reduce the swelling. I like to use a quick cast to keep it straight but allowing the other joints to bend. It also can be kept on while washing your hands and it will dry without messing up the skin. The compression also can help with the swelling. Another option is a custom fitted orthosis made of thermoplastic material, which is great but now when you take it on and off, you have to make sure that you keep that DIP from falling down.
A Recovery in Progress
So far so good. Looks great, she can move the other two knuckles with pain, but at least it’s becoming more functional. It’s not easy…we have to work to help reduce the swelling, and bend as much as possible the middle knuckle while keeping that little one straight.
Conservative treatment can take time. I think we have to start from the beginning and let it stay straight for at least 6 weeks while incorporating the small finger into her activities of daily living. If this doesn’t work, and the deformity of the mallet finger interferes with her function, then she will need to speak with her hand surgeon to explore other options. Surgical management will have to be another blog…
Have your own story? Let us know in the comment section! Have any questions about mallet finger treatment in Miami or hand therapy ? Please give us a call here at Hands on Therapy Services for more direct help and set up your therapy appointment!
Physical Therapy/Occupational Therapy for Mallet Finger – Trust Hands on Therapy Services in Miami!
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