Tanya Coats Occupational Therapy

Why won’t my fingertip straighten?

What is a Mallet Finger?

There are many reasons why a fingertip won’t straighten, but one of the most common is an injury called mallet finger.  What is mallet finger?  And how do we fix it?

A mallet finger is an injury that causes the fingertip to bend, making it impossible to straighten. We need to hold it up with the other hand or leave it flat on a table. When I was 10 years old I managed to do this injury on myself playing football, so I’m a bit of an expert on this injury. Now as a hand therapist I see more patients doing this injury by changing the bed sheets or taking off their socks.

There are two ways that a ‘mallet finger’ occurs.  The first is the way I did it many years ago where a small fracture called an ‘avulsion’ occurs.  This injury occurs when a sudden force bends the last joint of the finger.  I can tell you, this is generally painful.  What you’ll notice is that the last joint in your injured finger is bent and the fingertip will become red and swollen.

What is the cause of a Mallet?

Although this injury is more painful initially, it actually takes less time to heal.  You hand therapist will fabricate a splint that will hold the finger straight. Six week and a few weeks of therapy later, voila you’re well and truly on the road to having a straight finger again.

The second way to do this injury is by changing the bed sheets, or pulling a sock off.  This occurs when the tendon, the structure that attaches to the bone to straighten the finger, is broken.  My patients will usually tell me that this doesn’t hurt, there’s no obvious sign of injury other than the bent last joint.  Often patients don’t go see their doctor for a few weeks because it’s not sore. (it’s much easier to fix these injuries the earlier you’re seen, so make sure if you ever do this, or see someone who has, you point them in the right direction).  While this type of mallet finger can happen to anyone, it is far more prevalent with our older population.

What is the treatment for Mallet Finger?

A ruptured tendon will usually take a little longer to heal.  Your hand therapist will put a thermoplastic splint on your finger for up to eight weeks before starting you on some gentle exercises.  Regardless of how you do it, the best way of getting that finger straight again is through a thermoplastic splint. Your hand therapist will custom make this for your finger in the first consultation.

Sometimes the only thing that will get that finger straight is surgery.  Your hand therapist will assess your finger and may send you for a surgeon’s opinion.  The ways in which you can reduce your chance of surgery is to seek medical advise as soon as you have noticed that your fingertip is bent.

Article Reference: Melbourne Hand Rehab

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