Mallet Finger

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There are five fingers (also known as digits) attached to the human hand. The four fingers can be folded over the palm which allows the grasping of items. Each finger, beginning with the nearest to the thumb, has a name to distinguish it from the rest, which are the index finger, middle finger, ring finger, and little finger.

Mallet finger (also known as baseball finger) is a common athletic injury that affects basketball and baseball players’ routinely jammed fingers, however, the injury can occur because of a crushing accident in the workplace, or even due to a cut finger (such as working in the kitchen). Any rapid motion that jams the tip of a finger against an object can cause a mallet finger. Commonly, the index or middle fingers are mostly affected by the condition.

Causes & Symptoms of Mallet Finger

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A direct blow to the finger causes a mallet finger. Furthermore, the injury happens when you are trying to catch an object, but the object hits the top or tip of your finger rather than landing in the palm of your hand. If the object hits more than one finger, you could have multiple mallet finger injuries. Blunt trauma to a finger can rupture the extensor tendon or pull it away from the bone; it can also dislocate your finger joint.

Although most mallet fingers are caused by a hard blow to the finger during sports, they can also be the result of something that does not seem serious at first. Jamming your finger while reaching for something on a shelf or even tucking in a bedsheet can pull the tendon away from the bone and cause further pain and deformation of your finger.

Certain symptoms of mallet finger appear almost instantly as the injury occurs. Common symptoms of mallet finger include:

 

  • Inability to straighten your injured finger
  • Swelling
  • Bruising
  • Blood under the fingernail
  • Fingernail detached from the nail bed

Who gets Mallet Finger?

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Mallet finger is typically the result of an accident, often while playing a sport like baseball or basketball. Sports or activities where you catch a ball, or even activities like dodgeball where you are trying to avoid a ball, increase your risk of injuring the tendon in your finger. The most common areas that are impacted by mallet finger injuries are the middle, ring, and little fingers, most often on the dominant hand since this is the hand that you use instinctively to catch or reach for something.

Overall, the risk factors of sustaining a mallet finger are higher in athletes, construction workers, and mechanics.

How Does it Affect You - How Serious is it?

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Mallet finger is typically the result of an accident, often while playing a sport like baseball or basketball. Sports or activities where you catch a ball, or even activities like dodgeball where you are trying to avoid a ball, increase your risk of injuring the tendon in your finger. The most common areas that are impacted by mallet finger injuries are the middle, ring, and little fingers, most often on the dominant hand since this is the hand that you use instinctively to catch or reach for something.

Overall, the risk factors of sustaining a mallet finger are higher in athletes, construction workers, and mechanics.

Recommended Treatment & Rehabilitation

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Medical attention should be sought within the first few days after injury – it is very important to seek immediate attention if there is blood beneath the nail or if the nail is detached; this may be a sign of a nail bed injury or an open fracture.

In children, your doctor must first carefully evaluate and treat this injury promptly so that the finger does not later become deformed. There may also be an injury to the growing portion of the bone.

In addition, a hand surgeon will examine your finger and may make a diagnosis by noting the droop of the fingertip. He / she may push the finger into a straighter position and notice that it will not remain straight on its own. Physicians will often order X-rays to see if a piece of bone has pulled away (a fracture) and to make sure the joint is aligned. Injuries with even a little swelling may have a fracture as well. Your physician will also look for any cuts to the finger, bleeding, or detachment of the nail.

Most mallet finger injuries (in both children and adults) can be treated without the need for surgical treatment. They can initially be treated with splinting. A cold treatment should be applied immediately after injury, and the hand should be elevated. A tongue depressor or a clean popsicle stick can be safely taped to the finger to keep it straightened.

There are a wide variety of splints / casts for mallet fingers. The ultimate goal is to keep the fingertip straight until the tendon heals. In most cases, a splint will be worn at all times for approximately eight weeks. Over the next three to four weeks, the splint can be worn only during sleep and less frequently during the day. Your surgeon or hand therapist will provide instructions on how to wear a splint and will also show you exercises to help maintain motion at the middle joint so your finger does not become stiff. The finger typically regains acceptable function and appearance with this treatment; however, splinting may not always be successful if treatment is delayed.

Once the mallet finger has fully recovered, your surgeon or hand therapist will teach you exercises to regain motion at the fingertip. Many patients will have a very slight droop and may notice a small bump at the back of the finger after treatment. This usually does not cause any problems with performing a normal activity.

Surgery may be considered when a mallet finger injury has a large bone fragment or the joint isn’t properly aligned. In this situation, wires or small screws are used to realign the joint. Surgery may also be considered if wearing a splint is difficult or was not previously successful. Surgery may involve applying a wire to the finger to keep it straight, stitching the tendon together or making a new tendon, or fusing the joint so it stays straight. Your hand surgeon will then help recommend the proper treatment that suits well for you.

A healthcare provider or physiotherapy may recommend exercises to help you heal. Talk to your healthcare provider or physiotherapist about which exercises will help you and how to perform them properly and safely. Here are some exercises to ease symptoms linked to mallet finger:

 

Finger extension stretch

Hold your affected hand so that the palm is facing downward. Then, place your opposite hand around the last joint of your injured finger. Your thumb should be just below the joint, with the pointer finger and the other finger supporting the entire finger underneath. If you are having trouble relaxing the hand and fingers, try sitting down and propping your entire hand comfortably on a table for additional support. Next, gently push with the tip of the finger up toward the ceiling while keeping the rest of the finger still with the thumb. Finally, go as far as is comfortable without pain, holding this position for 20 seconds for 2-3 sets.

 

Extensor tendon glide exercise

Hold your hand out in front of you with your fingertips up toward the ceiling and as straight as possible. Make a duckbill shape with your fingers and thumb by keeping the finger and thumb joints straight while you bend at the knuckles only. Afterward, bring the palm side of the thumb and fingers as close to each other as possible without pain and avoiding bending of the distal and proximal interphalangeal joint. Hold this position for 5-10 seconds for 10-15 repetitions in total.

 

Power squeeze

Grab a small towel, a hand exercise ball, or anything else that you can squeeze. Next, hold your tool of choice in the palm of your affected hand, then wrap all of the fingers and thumb around it. Squeeze the ball in your hand as you attempt to further curl your fingers. Hold for 5 seconds for 10 repetitions, 2-3 times a day.

 

Fingertip pinch

Grab a small towel to pinch and sit in a chair near a table. Roll the towel into a narrow cylinder and place it in front of you on the table. Place your thumb and affected finger around the cylinder to pinch. Pinch the thumb and finger together as you focus on keeping an “O” shape with the fingers. Finally, hold for 3-5 seconds for 10 repetitions, 2-3 times a day. You can perform this exercise with your unaffected hand as well.

 

Full finger spread

First, grab a small resistance band, then bring all of your fingertips and thumb together in the center of your hand. Wrap the band around your fingers between the middle joint and the end of the finger. Extend all of the fingers and thumb away from each other as far as possible, pushing against the resistance. Lastly, keep the finger joints straight as you spread your fingers apart and extend them to what you can tolerate. Hold for 1-2 seconds and repeat for 10 repetitions, 2-3 times a day.

Alternative & Homeopathic Treatment

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Performing homeopathic treatments are helpful in cases of injuries such as a baseball finger. For instance, if the finger is cut, you can clean the cut under running water for a few minutes. Afterward, wrap the mildly injured finger with clean gauze or a clean cloth.

Finally, apply a moderate amount of pressure to help stop any further bleeding. Ice can also be a supportive at-home treatment for patients experiencing a mallet finger. Apply ice to the injured finger joint to help reduce swelling and tenderness. Then, wrap the ice in a towel (or an ice pack) and place the bag of ice on the affected area.

Besides the exercises mentioned earlier, there are certain tools that are easy to use and will help stretch and strengthen your fingers on the go or when you have a spare moment at home. Here are some tools that you can acquire and use, including the following:

 

Hand exercise balls

Hand exercise balls are a great addition to your hand exercise tool kit. They come in a variety of colors that differ in resistance, depending on your hand strength and where you are in your recovery journey. You can throw one in your bag and use it throughout the day to keep your hand strong. Additionally, squeezing a ball will promote circulation to enhance the healing process and reduce overall pain as well.

 

Therapy putty

The use of putty is a versatile tool for hand and finger strengthening. The ways you can use it are practically endless. It also comes in a variety of strengths that you can utilize with your rehab program. Many patients find the use of therapy putty therapeutic for their minds as well.

 

Grip rings

A grip ring can be considered a cross between the exercise balls and therapy putty. It is more versatile than the ball but has slightly less versatility than the putty.