Mallet finger - management and patient compliance

Mallet finger is a flexion deformity of the finger resulting from injury to the extensor mechanism at the base of the distal phalanx.

This article discusses the current clinical assessment and appropriate management of mallet finger injuries.

Mallet finger usually results from forced flexion of an extended finger. Treatment can be difficult as patient compliance is essential, and if not treated appropriately the injury can lead to permanent deformity. Patients will present with a flexion deformity of, and inability to actively extend, the distal interphalangeal joint. Closed mallet finger injuries are managed in a strict extension or hyperextension immobilisation splint for 8 weeks. Surgery is reserved for injuries involving fracture to greater than 30% of the articular surface, volar subluxation of the distal phalanx, avulsed fragments that fail reduction, injuries failing conservative management, and absence of full passive extension of the joint. Early referral is recommended if there is any concern.