Mallet finger occurs when you cannot straighten your finger at its last joint. When you do try to straighten it, the tip of your finger remains bent toward your palm.

Sports injuries are the most common cause of mallet finger, particularly from catching a ball.

Baseball finger - aftercare; Drop finger - aftercare; Avulsion fracture - mallet finger - aftercare

Tendons attach muscles to bones. The tendon that attaches to the tip of your finger bone on the back side helps you straighten your fingertip.

Mallet finger occurs when this tendon:

• Is stretched or torn
• Pulls a piece of bone away from the rest of the bone (avulsion fracture)

Mallet finger most often occurs when something hits the tip of your straightened finger and bends it down with force.

Wearing a splint on your finger to keep it straight is the most common treatment for mallet finger. You may need to wear a splint for different lengths of time.

• If your tendon is only stretched, not torn, it should heal in 4 to 6 weeks if you wear a splint all the time.
• If your tendon is torn or pulled off the bone, it should heal in 6 to 8 weeks of wearing a splint all the time. After that, you will need to wear your splint for another 3 to 4 weeks, at night only.

If you wait to start treatment or do not wear the splint as you are told, you may have to wear it longer. Surgery is rarely needed except for more severe fractures.

Your splint is made of hard plastic or aluminum. A trained professional should make your splint to make sure it fits correctly and your finger is in the right position for healing.

• Your splint should be snug enough to hold your finger in a straight position so that it does not droop. But it should not be so tight that it cuts off blood flow.
• You should keep your splint on unless your doctor tells you that you can take it off. Each time you take it off and bend your finger tip, it can lengthen your recovery time.
• If your skin is white when you take off your splint, it may be too tight.

You will likely be able to return to your normal activities or sports, as long as you wear your splint all the time.

Be careful when you take off your splint to clean it.

• Keep your finger straight the whole time the splint is off.
• Letting your fingertip droop or bend may mean you will have to wear your splint even longer.

When you shower, cover your finger and splint with a plastic bag. If they get wet, dry them after your shower. Keep your finger straight at all times.

Using an ice pack can help with pain. Apply the ice pack for 20 minutes, every hour you are awake for the first 2 days, then for 10 to 20 minutes, 3 times daily as needed to reduce pain and swelling.

For pain, you can use ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or acetaminophen (Tylenol). You can buy these pain medicines at the store.

• Talk with your health care provider before using these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or internal bleeding in the past.
• Do not take more than the amount recommended on the bottle or by your provider.

When it is time for your splint to come off, your provider will examine how well your finger has healed. Swelling in your finger when you are no longer wearing the splint may be a sign that the tendon has not healed yet. You may need another x-ray of your finger.

If your finger has not healed at the end of treatment, your provider may recommend another 4 weeks of wearing the splint.

Call your provider if:

• Your finger is still swollen at the end of your treatment time
• Your pain gets worse at any time
• The skin of your finger changes color
• You develop numbness or tingling in your finger

Kamal RN, Gire JD. Tendon injuries in the hand. In: Miller MD, Thompson SR, eds. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 73.

Strauch RJ. Extensor tendon injury. In: Wolfe SW, Pederson WC, Kozin SH, Coshen MS, eds. Green's Operative Hand Surgery. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 5.