Hello, I am Dr. Ayisha Livingstone, MD, a Fellowship trained and Board-Certified Orthopedic Hand Surgeon. I reside and practice in Fort Lauderdale, Florida with the South Florida Orthopedic Group. I completed my Orthopedic Residency at the University of Miami, and my Fellowship at the University of Pittsburgh.
I genuinely love my community here in South Florida and decided to help bring awareness on some common hand and wrist ailments that present to my practice. Once a month I will post a new topic on the website. Please feel free to use the contact information to see me or my colleagues with any questions or concerns.
April 2024 Hand Surgery Topic
Mallet Finger/Injury
What is it?…
A mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb. This joint is called the distal interphalangeal (DIP) joint in the fingers and the interphalangeal (IP) joint in the thumb.
The injury can happen when an unyielding (rigid or solid) object (like a baseball) strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. As a result of the injury, you are not able to straighten the tip of your finger or thumb on your own, resulting in a bent posture of the tip of the digit.
Symptoms may include:
- A bruised and swollen fingertip
- The fingertip may noticeably droop.
- The fingertip will not actively extend (it will only straighten if you push it upwards)
- If there is an open wound associated with the injury, it is important to seek attention quickly. You do not want to risk an infection or an associated fracture.
What should you do:
- Ice the fingertip and elevate it to decrease pain and swelling.
- Acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen and naproxen, may help with the pain.
- You can create a well-padded splint for the tip of the digit, but make sure the splint is not so long that it prevents motion of the uninjured joints.
- Seek an evaluation with a hand surgeon as soon as possible, ideally within a week of the injury.
Anatomy:
Mallet finger injuries are caused by the disruption of the extensor mechanism of the phalanx (end bone) at the level of the distal interphalangeal joint.
Sometimes the tendon pulls a small piece of the bone off with it. This is called an avulsion fracture. The injury is then a “Bony Mallet” injury.
My Examination:
- We will discuss your medical history and symptoms, then I will examine the injured digit.
- I will hold the affected finger and ask you to straighten it on your own. This is called the mallet finger test.
- I will also get X rays to determine if there is an associated fracture.
- The x rays will also show if the joint has been pulled out of alignment by the injury or if the fracture piece is larger than expected.
Treatment
Although it is a gradual process, most patients, depending on the severity of the injury, will benefit from an initial period of conservative management.
If you feel as if you or any of your family and friends could have any of the symptoms provided here, medical care is available. Dr Ayisha Livingstone is a Fellowship Trained and Board-Certified Orthopedic Hand Surgeon in Fort Lauderdale, FL. To learn more or book a consultation, click here.
