Treatment Options for Mallet Finger

Table of Contents

Mallet finger, also known as ‘baseball finger’, occurs when the tendon responsible for straightening the fingertip is injured, leading to a drooping tip that cannot be actively extended. This condition is often caused by direct trauma or forced bending of the fingertip and can vary in severity. In this article, we explore the symptoms, causes, and treatment options for mallet finger to help manage and restore finger function.

Symptoms and Causes of Mallet Finger

Mallet finger typically occurs due to sudden trauma or forceful bending of the fingertip, causing damage to the extensor tendon. Common causes include direct impact during sports, such as being struck by a ball, or accidental hyperflexion during daily activities. Symptoms include an inability to straighten the fingertip, visible drooping, pain, swelling, and sometimes bruising around the joint. In some cases, weakened tendons from underlying conditions like arthritis can predispose individuals to this injury.

Non-Surgical Treatment Options

Non-surgical approaches are often the first line of treatment for mallet finger, particularly in cases where the injury does not involve significant bone damage or joint misalignment. These methods focus on stabilising the finger and managing symptoms to promote natural healing.

Splinting

Splinting is the most common non-surgical treatment for mallet finger. A splint keeps the fingertip in an extended position, allowing the damaged tendon to heal in its proper alignment. The splint must usually be worn continuously for 6–8 weeks, and part-time use may follow for another 2–4 weeks. Maintaining the correct position of the finger during this period is necessary to avoid complications or delayed healing. Proper hygiene is also needed, as prolonged splint use can irritate the skin if not cleaned regularly.

Pain Management

Pain associated with mallet finger can often be managed with over-the-counter medications such as paracetamol or ibuprofen. These medications help reduce discomfort and control inflammation during the healing process. If pain persists or worsens, a medical professional should be consulted to evaluate the injury further. It is necessary to use pain relief medications as directed to minimise potential side effects.

Surgical Treatment Options

While non-surgical methods are effective for many cases, surgery may be necessary when the injury is more severe. Surgical options are designed to repair extensive tendon damage or address bone fractures to restore proper finger function.

Tendon Repair

Tendon repair surgery is performed when the extensor tendon is severely damaged or non-surgical methods are ineffective. The procedure involves reattaching or repairing the tendon to restore the ability to straighten the fingertip. In some cases, a pin may be temporarily inserted to stabilise the joint during recovery. After surgery, the finger is immobilised with a splint or cast, followed by physiotherapy to regain strength and mobility. Recovery times can vary depending on the extent of the injury and the success of rehabilitation efforts.

Bone Fragment Fixation

Bone fragment fixation is necessary when mallet finger involves a fractured bone at the fingertip. The surgeon secures the detached fragment using small screws, wires, or pins to ensure proper alignment and stability. This approach helps both the bone and tendon heal effectively, reducing the risk of complications such as arthritis. After surgery, follow-up care is necessary to monitor progress and address any issues that arise during recovery.

Prevention and Management

Effective prevention and management strategies are necessary for supporting recovery from mallet finger and reducing the risk of future injuries. A combination of careful monitoring, targeted exercises, and protective measures can help ensure long-term finger health.

Follow-Up Care

Regular check-ups with a healthcare provider help monitor the progress of healing and address any concerns that may arise. These visits may include imaging tests to confirm that the tendon or bone is properly aligned and healing as expected. Early intervention for any issues can prevent complications.

Strengthening and Flexibility Exercises

After the finger is stabilised, gradual exercises focused on improving strength and flexibility can aid recovery. Beginning with gentle movements and advancing to more robust exercises helps restore function without overloading the tendon or joint. A physiotherapist can guide this process to ensure it is both effective and safe.

Protective Measures

To prevent re-injury, avoid high-impact activities or heavy strain on the recovering finger. Using a protective splint or guard during activities that pose a risk can help shield the finger from accidental trauma. Simple precautions, such as careful handling of objects or avoiding forceful gripping, further reduce the chances of setbacks.

Conclusion

Mallet finger is a common injury that, when addressed promptly, often heals well without long-term complications. Recognising its symptoms and its causes can help in seeking timely medical attention. Both non-surgical and surgical treatments offer effective solutions, and following a structured aftercare plan ensures the best chance for recovery.

If you suspect a mallet finger injury, schedule a consultation to determine the best course of action.

Dr. Chee Kin Ghee

Specialist Hand & Orthopaedic Surgeon

Dr Chee Kin Ghee is a specialist hand surgeon with over 20 years of experience in hand and orthopaedic surgery.

His clinical expertise includes treatments for complex hand, wrist, and upper limbs injuries, wrist and finger joint replacement, minimally invasive hand and wrist surgery, and nerve compression release surgery

Dr Chee was awarded a 1-year fellowship (HMDP by MOH) & trained at world-renowned Wrightington Hospital Upper Limb Unit, UK.
He was trained in the management of complex upper limb conditions, including complex joint replacement of the shoulder, elbow, wrist, and hand, as well as modern minimally invasive upper limb surgery.

Dr. Ambrose Yung

Specialist Orthopaedic Consultant

Dr Ambrose Yung Wai Yin is an experienced Specialist Orthopaedic Consultant with over 20 years of experience in the field of orthopaedics.

His area of interest extends includes complex operations such as revision knee arthroplasty, partial knee replacement and primary total knee replacement. His area of expertise also extends to minimally invasive shoulder, ankle and knee surgery as well as reconstruction of the upper and lower limbs.

Dr. Low Mun Hon

Dr Low Mun Hon has over 20 years of experience managing trauma and orthopaedic clinical care. Prior to this, he has been in private practise as a practitioner at Singapore Sports & Orthopaedic Clinic (SSOC).

Dr. Low graduated from Monash University Medical School (Melbourne). Thereafter, he pursued his internship at The Alfred Hospital in Melbourne.

He subsequently continued his practice of medicine at Singapore General Hospital (SGH). During this period, he was awarded the membership of the Royal College of Physicians and Surgeons at Glasgow in 2008 & Master of Medicine in Orthopaedic Surgery (National University of Singapore) in the same year.
Dr Low had previously worked as an orthopaedic trainee at various local teaching hospitals i.e. Ng Teng Fong General Hospital (NTFGH), Tan Tock Seng Hospital (TTSH), KK Women’s and Children’s Hospital (KK Hospital) and Singapore General Hospital (SGH).

Justin Lim Xuan Li

Physiotherapist

Justin is a skilled and experienced physiotherapist who specializes in the treatment of neuro-musculoskeletal conditions (nerve, muscle and joint).

Over the years, he honed his clinical skills across all sectors of healthcare, allowing him to attain mastery of the sophisticated human body and address complex problems effectively, allowing him to successfully address complex neuro-musculoskeletal conditions at an accelerated pace.

Justin graduated from Trinity College Dublin and started his career in National Healthcare Group Polyclinics. His skills quickly gained recognition and was appointed as a clinical educator for physiotherapy students and even tasked to develop Clinical Practice Guidelines.
Subsequently, he continued his practice in community care settings such as Thye Hwa Kwan Rehabilitation Centres and Saint Andrew Community Hospital, where he focused on developing his skills for geriatric rehabilitation and improving quality of care in rehabilitation centres. He then moved on to private practice in Parkway East Hospital, specializing in post operative and outpatient rehabilitation.

Chan Jing Cheng (JC)

Physiotherapist

JC has over 12 years of experience in treating Chronic pain, Orthopaedic and Geriatric conditions.

He had worked at various Private Hospitals, Singapore General Hospital, NTUC Health Elder Care and Lions Home for the Elders.
He is passionate about solving complex musculoskeletal disorders and helping clients relief pain from trauma and illness.
He has a special interest in the Shoulder, Spine, Hip and Knee joint conditions.
He has helped thousands of clients go through rehabilitation smoothly and achieved higher satisfaction after orthopaedic surgery.

Zita Sham

Physiotherapist

Zita graduated with a Diploma in Physiotherapy from Nanyang Polytechnic (Singapore) in 2014 and started working in Ng Teng Fong General Hospital to serve her sponsorship bond.

Later in 2015, she pursued a Bachelor’s Degree in Physiotherapy from Trinity College Dublin, which was provided in Singapore Institute of Technology.

After completion of her studies, Zita worked in the Day Rehabilitation Centre in Jurong Community Hospital for 6 years, where she focused on community rehabilitation for a variety of patients. Patients that were mainly seen consisted of post-operative, geriatric and neurological conditions.
Zita also has a passion in musculoskeletal and sports physiotherapy and is looking to pursue that. She is also keen to provide home-based physiotherapy to reach out to those in need of her expertise.

Joanna Lim

Hand Occupational Therapy

Joanna’s primary specialization and passion is in hand therapy and upper limb rehabilitation, having more than 10 years of experience in this field.

Joanna obtained her Diploma in Occupational Therapy (Merit) from Nanyang Polytechnic in 2006. Under the MOH Health Science Scholarship, she graduated from La Trobe University, Australia, with a Bachelor’s degree in Occupational Therapy (1st class Honors) the following year. Upon graduation, she worked in Changi General Hospital and Sengkang General Hospital.

She has worked with hand and orthopedic surgeons in both inpatient and outpatient settings, providing quality therapy services for clients with a variety of hand and upper limb conditions, including fractures, sprains/strains, tendon injuries, nerve injuries, repetitive strain disorders and complex trauma injuries.
During her tenures at CGH and SKGH, Joanna was a Senior Occupational Therapist and held the role of Hand Therapy and Upper Limb Rehabilitation Unit Leader. She was in charge of clinical supervision and management of staff, manpower planning, and daily operations of the unit.

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