Mallet Finger

Mallet finger, also known as drop finger or baseball finger, is a tendon injury that typically occurs at the end of the finger or thumb. It can affect anyone when an object strikes the thumb or tip of the finger, forcing it to bend further than intended.

People who play sports such as baseball, basketball, football or volleyball are most likely to develop mallet finger. Fortunately, it’s possible to treat this injury with ice, a splint or, in rare cases, surgery. Keep reading to learn the symptoms of baseball finger, its causes and how doctors address this condition.


What Is Mallet Finger?

Mallet finger is an injury that straightens the top of your finger or thumb further than intended. It frequently occurs in sports like football or baseball when you try to catch a hard ball, and it hits your fingertip. Your dominant hand’s middle, ring and pinky fingers are most likely to experience it.

Baseball finger causes complications with the tendons and pulleys in the hand that bend the fingers. These tendons work like cords, connecting the forearm muscles to the bones of the fingers and thumb to provide stability and motion. When injured, the pulley at the base of the finger thickens and constricts the tendon, making it difficult for it to move freely.

The tendon might tear or even detach from the finger bone with a mallet finger injury. In some cases, it might damage the finger bone and tendon. The injury can also cause swelling or inflammation.

What Causes Mallet Finger?

In sports, mallet finger injury often occurs when something strikes a hand, forcefully bending the outermost finger or the last joint. It typically ruptures the tendon, causing the athlete difficulties when attempting to straighten the finger. The injury might also occur due to a crushing accident on the job or a cut finger while working in the kitchen. Pain typically shoots up around the top of the finger behind the nail.

The degree of deformity relates to the injury level. Sometimes, mallet finger can cause a joint fracture if the affected tendon connects to a piece of bone. With a condition called an avulsion injury, the bone fragment may pull away from the tendon.

What Are the Symptoms of Mallet Finger?

When a mallet finger injury occurs, you’ll find it impossible to straighten your finger on your own. It may also noticeably droop at the tip, and you might experience pain, tenderness and swelling immediately after the injury. It can also be painful and appear bruised and red.

The primar symptoms of mallet finger include:

  • Pain
  • Swelling
  • Bruising
  • Tenderness
  • Detached finger
  • Redness under the fingernail bed
  • Inability to extend the fingertip without help

To relieve pain and reduce swelling, apply ice to your finger immediately after the injury occurs and keep your hand elevated above your heart.

You must seek immediate medical attention if there is blood beneath the nail or your fingernail becomes detached. These may be signs of a cut in the nail bed or a broken finger bone causing an open fracture — where the wound penetrates the bone. These types of injuries increase your risk of infection.

Diagnosing Mallet Finger

To confirm the diagnosis of mallet finger, doctors will evaluate your medical history and discuss your symptoms. They’ll then examine your finger and thumb, usually holding the affected finger while asking you to straighten it independently.

When diagnosing mallet finger, physicians typically notice three types of injuries:

  • Tendon damage with no fractures present
  • A ruptured tendon with a minor fracture
  • A ruptured tendon with a large fracture

During a clinic visit, a physician can evaluate your symptoms, perform a physical exam and order diagnostic imaging tests like an X-ray, ultrasound or magnetic resonance imaging. An MRI or ultrasound will be more effective if your physician suspects bone fragments in the affected area. An X-ray will identify bone injuries to determine whether the joint is partially dislocated or subluxated.

How to Treat Mallet Finger

Mallet finger treatment will depend on the type of injury you’ve sustained and the severity of your symptoms. Based on your physician’s analysis, they’ll recommend a treatment plan consisting of non-surgical or surgical options.

Non-Surgical Mallet Finger Treatment

The non-surgical treatment for baseball finger involves splinting and oral anti-inflammatory medications to relieve the injury.

If the injury involves the tendon, your doctor will likely recommend splinting the finger joint in full extension for eight weeks. A baseball splint holds the fingertip straight until it can fully heal. It’s essential to keep your finger straight when removing the splint for cleaning and drying. If the fingertip droops, it will disrupt healing, requiring you to wear the baseball finger splint for a longer period.

Your doctor may schedule periodic checkups over the eight weeks to monitor your progress. You’ll gradually wear the splint less frequently a few weeks after the initial splinting period. Splinting typically results in proper functioning and appearance, though some patients may require surgery if they do not regain full extension.

After the splint comes off, mallet finger exercises can begin. Movement will prevent stiffness. If the finger joint droops at any point, you’ll need to put the splint back on for an additional few weeks and delay all motion.

Surgical Treatment

Your doctor may recommend mallet finger surgery if there is a large fracture fragment or your joint becomes misaligned. In these cases, they’ll repair the fracture with pins to hold the pieces of bone together until the injury heals. They may also take a tendon graft or use tissue from another part of your body to repair the damaged tendon. Stiffer mallet finger injuries may develop wound issues, so surgery is often vital. Mallet finger surgery is low-risk, and most patients experience a full recovery.

Mallet Finger Recovery

Mallet finger recovery time varies depending on the person. Active finger mobility generally occurs immediately after surgery. Patients can use their hand as usual and resume their activities as long as comfort permits. Patients might need to wear a baseball finger splint at night for a month to prevent the deformity from reoccurring.

For injuries requiring surgery, physical therapy is crucial. After completing a splinting program, a therapist will need to help the patient restore motion to the finger and return it to a healthy state.

The physical therapy timeline may require six weeks of participation and multiple weekly sessions. These sessions usually involve hand treatments, stretching exercises and soft-tissue massage to broaden range of motion. Mallet finger exercises can strengthen joints and hand muscles to improve fine motor skills and dexterity.

Request an Appointment With the Hand Center of Louisiana

While this condition can be uncomfortable, most patients usually expect a full mallet finger recovery when undergoing professional treatment.

At the Hand Center of Louisiana, we have over 40 years of experience with non-surgical and surgical treatment of hand conditions. We remain committed to providing high-quality care that optimizes your comfort, convenience and support.

To request an appointment, fill out our online form today.