Mallet Finger
Mallet Finger picture album Several pictures illustrating mallet finger and its treatment. Mallet Finger video 3D animation demonstrating the anatomy and treatment of a mallet finger. Extension Block Pinning of a Mallet Finger video 3D animation demonstrating a common surgical approach to a bony mallet finger.
A mallet finger is a condition that results in a drooping finger tip.  It occurs because of an injury to the extensor tendon where it attaches to the distal phalanx--the bone at the tip of the finger. The end of the extensor tendon of the finger attaches to the back side of the base of the distal phalanx.  As muscles in the hand and forearm contract, they pull on the extensor tendon and extend the finger tip.  If the tendon is detached from the distal phalanx, there is nothing to pull back on the bone and extend the finger tip.  And so the finger droops. Mallet fingers are often the result of a blow to the fingertip that ruptures the tendon from its attachment.  The condition is sometimes called baseball finger because it can occur when a baseball "jams" the finger. Mallet fingers can also occur because of a tendon laceration.  For example, a knife may slice across the extensor tendon and sever it.  When a fracture occurs at the base of the distal phalanx where it attaches to the extensor tendon, it is known as a "bony mallet finger."  The tendon is able to pull only on the broken fragment and the finger tip droops. Treatment for mallet fingers is usually non-surgical.  The finger is placed into an extension splint or stax splint which holds the finger tip in extension for six to eight weeks.  This allows the tendon to heal back to its attachment site. If the injury is the result of a laceration, the tendon must be repaired with stitches. Bony mallet fingers can also be treated without surgery if they involve only a small fragment of bone.  If the fragment is too large, many orthopedic surgeons recommend surgical fixation.  This is usually done with a pin.