Mallet Finger Info Evidence
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
Also on YouTube.
Video transcript
You might notice your fingertip drooping after a ball strikes the tip of your finger during sport or your fingertip catches on a sheet or sleeve. The most noticeable change is that the tip hangs downward and you cannot straighten it yourself, even though bending it remains perfectly normal. Day to day, this often means struggling to button a shirt, type on a keyboard, or pick up small flat items. Many people delay getting it checked because the discomfort is mild and the finger still handles most tasks. Starting treatment early makes a real difference to how well the finger recovers. The swelling and bruising usually appear over the back of the last joint, while the pain tends to stay quite mild. You will likely find that the finger still works for everyday activities, which is why some patients wait before seeking advice. The most striking sign remains the downward droop of the fingertip that refuses to lift without help. Catching these changes early helps protect the delicate structures inside the tip. A thin band of tissue called the extensor tendon sits along the back of your finger and normally pulls the tip straight. When the injury happens, this tendon either tears near the nail or pulls a small piece of bone away with it. Because the connection is broken, muscle force cannot reach the last joint, leaving the fingertip to hang down. The damaged ends must stay perfectly aligned for several weeks so they can knit back together. Allowing the tip to bend even briefly during this time stretches the healing tissue and can make the droop permanent. Most cases are managed without surgery using a small plastic splint that holds the tip joint completely straight around the clock for six to eight weeks. The splint must never be removed, even for washing, because letting the fingertip bend resets the healing process. Many patients then wear the device only at night for a few extra weeks once the continuous phase finishes. Surgery is sometimes recommended when a large bone fragment has shifted out of place or when the injury breaks the skin. The bone piece may be pinned back into position during the procedure. Even injuries that have been present for more than several weeks are still worth treating, though the recovery tends to be less complete. Once the splinting period ends, the finger often feels quite stiff and may show a slight droop at first. Gentle hand therapy exercises are introduced gradually to help restore normal movement and strength. Most people end up with a finger that functions normally, though a few degrees of permanent droop can sometimes remain. It is best to show the droopy fingertip to a clinician within a few days of the injury so treatment can begin promptly. You should seek same day attention if there is an open wound near the joint, or if you notice numbness, tingling, coldness, or a dusky colour in the finger. Continuing home splinting is fine, but you will need a professional review if the droop has not improved by the end of the recommended period.
What you're feeling
You will likely notice that the tip of your finger droops and cannot straighten on its own. This happens because the tendon that lifts your fingertip is damaged. You might feel a sharp pain right at the last joint of your finger when you first get hurt. The pain usually settles down, but the joint may feel stiff or weak.
Simple tasks become difficult because you cannot grip or pinch properly. You may struggle to type on a keyboard without the finger catching. Buttoning a shirt or zipping a bag can feel awkward and painful. Trying to pick up small items like coins or keys might cause the finger to buckle under pressure. Even holding a coffee cup can be uncomfortable if you need to use that hand for support.
The pain often flares up after you have been using your hand for a while. You might notice more stiffness when you first wake up in the morning. Some people feel a dull ache at night, especially if they roll onto their hand while sleeping. The discomfort tends to get worse with activities that require fine motor skills or heavy lifting.
In some cases, you might see a small bump or bruise near the joint. This can happen if a piece of bone has pulled away with the tendon. If you have bilateral injuries, you may feel these symptoms in both hands at the same time. While most injuries respond well to non-surgical treatment with a splint, severe cases involving larger bone fragments or joint instability may require different care. Your surgeon will assess the extent of the damage to determine the best path forward for your specific situation.
What's actually happening
Mallet finger happens when the tendon that straightens your fingertip stops working. This tendon, called the terminal tendon, attaches to the very end bone of your finger. It acts like a rope that pulls your finger up. When this rope tears or pulls a piece of bone away, you lose the ability to lift the tip of your finger on your own.
The injury usually occurs when something catches your straight finger and bends it down suddenly. This force snaps the tendon or breaks off a small chip of bone from the joint surface. The result is a drooping fingertip that stays bent. You cannot actively straighten it. However, you can still move the joint fully if someone else moves it for you.
Your fingertip rests in a flexed posture because the opposing muscle, which bends the finger, pulls it down without resistance. The tendon on top is no longer holding it up. This imbalance creates the visible deformity. Whether the injury is just to the soft tissue or involves a small bone fragment, the appearance and function loss look similar. The bone fragment usually includes the tendon attachment, so the mechanical problem is the same.
This condition most often affects the small, ring, or middle fingers of your dominant hand. It is more common in men but can happen to anyone aged 11 and older. In children, the injury may involve the growth plate of the bone rather than the tendon itself. In older adults with wear-and-tear arthritis, similar deformities can occur without a specific injury. The key issue is always the disruption of the force that extends the joint tip.
What we can do about it
How Dr Kieran Hirpara, an upper-limb surgeon at Mater Private Hospital Rockhampton, approaches this in our clinic reflects a clear pathway. Patients reach us via GP or physiotherapist referral. We start with a full assessment to confirm the diagnosis. For most mallet finger injuries, we begin with non-surgical care. This involves splinting the tip of your finger in a straight position. A hand therapist can manage this treatment as effectively as a surgeon. We use a dorsal glued splint for most cases. You wear this continuously to let the tendon heal. We do not recommend supplemental night splinting, as it does not improve outcomes. You should give this conservative approach enough time to work before considering other options.
We manage pain and swelling with standard medications. If you have a bony fragment, we monitor it closely. We do not routinely use injections for acute mallet finger. The goal is to keep the joint straight while the tissue repairs itself. If you have a chronic injury where the tendon has scarred, we may discuss surgical repair. This is considered if conservative care has not helped or if you cannot wear a splint due to work requirements. We also consider surgery if the fracture involves more than one-third of the joint surface or if the bone slips out of place.
Surgery is a reserved option for specific cases. It is generally indicated when conservative treatment fails or when the injury involves a large bone fragment. The procedure aims to restore the tendon’s attachment so you can straighten your finger tip again. We discuss this as a shared decision, weighing the benefits against the need for postoperative splinting and wire protection. Most mallet fingers heal well with simple splinting, but we are ready to offer surgical salvage if your specific injury requires it.
What to expect
Most mallet finger injuries settle well without surgery. You will likely wear a splint to keep the tip of your finger straight. This allows the tendon or bone to heal in the correct position. Both splinting and surgery lead to strong clinical results. Your surgeon will choose the path that fits your specific injury.
Recovery is a process of patience. You must keep the splint on continuously for several weeks. Do not remove it to wash or bend the finger. If you do, the tendon may stretch out again, and you will have to start over. Supplemental night splinting does not improve your final outcome. It adds no benefit to your extensor lag, disability, or satisfaction with treatment.
If your injury involves a large bone fragment or joint misalignment, surgery may be recommended. This is often called a mallet fracture. Your surgeon may use wires to hold the bone in place. These procedures report good to excellent long-term results. In some series, no complications such as infection or nail deformity were observed. However, full correction of the drooping finger is less consistent if your deformity was severe before surgery.
If left alone or managed poorly, the finger may remain bent. This is called an extensor lag. It can cause stiffness and difficulty with fine motor tasks. In cases involving significant bone fragments, there is a risk of the joint slipping out of place. Approximately 50% of patients with large fractures do not progress to this subluxation. However, fracture size and delayed treatment increase this risk.
Your outlook depends on how strictly you follow the immobilization plan. Most patients regain full function. Some may have a small, permanent droop at the tip of the finger. This is common and rarely affects daily life. Your surgeon will guide you through the process. We aim for a straight, functional finger that supports your normal activities.
When to see someone
See your GP or ask for a specialist review if you notice persistent pain that does not improve with rest. Seek care if you experience weakness or instability in the finger. Watch for locking or giving way during movement. Contact a doctor if symptoms interfere with your sleep or work. Sudden worsening of the injury also warrants prompt attention. While many cases heal well with simple splinting, your surgeon needs to assess the joint surface. This is especially important if the fracture involves more than one-third of the joint. Early assessment helps prevent long-term stiffness or deformity.
Evidence & references
Overview
- Absolute indications for surgical intervention for mallet fingers in pediatric populations remain unclear [1].
- Large-fragment mallet finger cases can be effectively managed conservatively with low complication rates [2].
- Most mallet finger injuries can be managed non-surgically with splinting [3].
- Surgery is occasionally recommended for acute or chronic mallet finger cases or for salvage of failed prior treatment [3].
- Both surgical and nonsurgical treatments of mallet finger injuries lead to excellent clinical outcomes [4].
- All cases of mallet finger are proposed to be treated with a dorsal glued splint except for stage IV mallet finger, which is treated with extra-articular pinning [5].
- A simple splint is recommended as an alternative means of treating mallet finger [8].
- Surgery is generally indicated in mallet fractures involving more than one-third of the articular surface [9].
- Surgery is generally indicated in all patients who develop volar subluxation of the distal phalanx [9].
- A significant advantage of surgical management over conservative management in complicated cases (large fragment or volar subluxation) has yet to be clearly proven [9].
- The majority of hand fractures can be treated without surgery, though surgery offers distinct advantages in properly selected cases [12].
- Pullout wire fixation together with distal interphalangeal joint Kirschner wire stabilization for acute combined tendon and bone (double level) mallet finger injury reports good to excellent long-term results with no reported complications such as infection, nonunion, or nail deformity [13].
- Central slip tenotomy with distal repair is a technique described for severe chronic mallet fingers with deformities exceeding 36 degrees [18].
- Full correction of extensor lag is less consistent with greater degrees of preoperative flexion deformity in severe chronic mallet fingers treated with central slip tenotomy and distal repair [18].
- The Ishiguro extension block technique produces satisfactory results and is effective and minimally invasive for mallet finger fractures when properly applied [54].
Anatomy & Pathophysiology
- Mallet finger deformity is characterized by a loss of active distal interphalangeal (DIP) joint extension with full passive range of motion evident [19].
- The deformity reflects the loss of normal extensor force transmission via the terminal tendon insertion onto the distal phalanx [19].
- The unopposed flexor digitorum profundus pulls the distal joint into flexion [19].
- The usual mechanism of injury involves sudden passive flexion of an actively extended DIP joint [19].
- Disruption of the terminal tendon may be entirely confined to the tendon or may involve an avulsed fracture fragment from the dorsal lip of the distal phalanx proximal articular surface [19].
- The clinical appearance of soft tissue and bony mallet fingers is similar because the avulsed fragment includes the terminal tendon insertion [19].
- The distal joint rests in flexion, a posture that cannot be actively changed [19].
- Full passive extension of the DIP joint is possible in mallet finger [19].
- Mallet finger most commonly involves a closed rupture of the terminal tendon with or without associated fracture of the distal phalanx [37].
- Snagging the extending finger on an object that suddenly flexes the DIP joint is a frequent cause of mallet finger [37].
- Less commonly, a forceful hyperextension injury of the DIP joint may result in a large fracture of the base of the distal phalanx involving one-third or more of the articular surface [37].
- Elderly patients with osteoarthritis of the DIP joint may have mallet deformities that are not related to trauma [37].
- Individuals with hyperlax joints may have multiple pseudomallet swan neck postures that are unrelated to trauma [37].
- Open mallet injuries are uncommon [37].
- The most frequently involved digits are the small, ring, and middle fingers of the dominant hand [37].
- There is a male predominance in mallet finger incidence [37].
- Tendinous mallet fingers have been reported to occur from age 11 onward [37].
- In skeletally immature individuals, a transepiphyseal plate fracture may be seen instead of tendon rupture [37].
- There may be a familial predisposition to mallet fingers [37].
- Displacement of the epiphysis of the distal phalanx can cause the digit to assume a mallet finger posture [14].
- Hyperextension of the phalanx usually affords satisfactory reduction of a displaced epiphysis [14].
- The extensor apparatus of the fingers includes the interosseous muscle, extensor digitorum communis tendon, lumbrical muscle, flexor tendon sheath, sagittal bands, transverse metacarpal ligament, interosseous hood, interosseous hood oblique fibers, extensor lateral band, extensor middle band, interosseous middle band, interosseous lateral band, oblique retinacular ligament, central extensor lateral, spiral fibers, transverse retinacular ligament, lateral extensor tendon, triangular lamina, and terminal extensor tendon [14].
- Injuries to the finger extensor apparatus are very common and may produce chronic deformity and loss of function [34].
Classification
- Absolute indications for surgical intervention for mallet fingers in pediatric populations remain unclear [1].
- Doyle type 4c mallet finger cases can be effectively managed conservatively with low complication rates [2].
- Most mallet finger injuries can be managed non-surgically with splinting, although surgery is occasionally recommended for acute or chronic cases or for salvage of failed prior treatment [3].
- Both surgical and nonsurgical treatments of mallet finger injuries lead to excellent clinical outcomes [4].
- All cases of mallet finger are proposed to be treated with a dorsal glued splint except for stage IV mallet finger, which is treated with extra-articular pinning [5].
- Approximately 50% of patients with a mallet fracture involving more than one-third of the articular surface of the distal phalanx do not progress to subluxation of the DIP joint [6].
- Fracture size and time to application of finger immobilizer are independent risk factors for the development of DIP joint subluxation in mallet fracture [6].
- A simple splint is recommended as an alternative means of treating mallet finger [8].
- Deepithelialised pedicled skin flap technique is a new reliable alternative in the treatment of chronic mallet finger [11].
- A hand therapist can treat mallet finger injuries of type 1 as effectively as a surgeon, with a method of immobilisation that offers practically no complications regarding skin condition [16].
- A modification to the Doyle classification is proposed to make it more encompassing and less prone to interobserver error [35].
- The interrater reliability of the Kellgren & Lawrence and OARSI classification systems for post-traumatic osteoarthritis in the distal interphalangeal joint after mallet finger fractures is considerably lower than initially assumed [41].
- Non-operative management of mallet fractures, regardless of fracture classification, joint congruence or pre-existing degenerate change in the DIP joint, is safe and yields predictably good outcomes in most patients [46].
- Most acute mallet fingers can be treated by continuous splinting, while fracture dislocations require open reduction and internal fixation [50].
Clinical Presentation
- Mallet finger injuries can present as bilateral cases [21].
- Biochemical abnormalities may play a role in the etiology of mallet fingers [21].
- Mallet finger injuries can involve a rare combination of tendon avulsion and fracture in juvenile patients [26].
Investigations
- Mallet finger deformity is characterized by a loss of active distal interphalangeal (DIP) joint extension with full passive range of motion evident [19].
- The deformity reflects the loss of normal extensor force transmission via the terminal tendon insertion onto the distal phalanx [19].
- The unopposed flexor digitorum profundus pulls the distal joint into flexion [19].
- The usual mechanism of injury involves sudden passive flexion of the actively extended distal interphalangeal joint [19].
- Disruption of the terminal tendon may be entirely confined to the tendon or may involve an avulsed fracture fragment from the dorsal lip of the distal phalanx proximal articular surface [19].
- Because the avulsed fragment includes the terminal tendon insertion, the clinical appearance of soft tissue and bony mallet fingers is similar [19].
- The distal joint rests in flexion, a posture that cannot be actively changed [19].
- Full passive extension of the distal interphalangeal joint is possible [19].
- A radiograph should be obtained to determine whether a fracture is present [19].
- If a fracture is present, radiographs should assess whether the dorsal fragment is large and whether the distal phalanx is subluxed palmarward [19].
Treatment
Non-Operative Management
- Most mallet finger injuries can be managed non-surgically with splinting [3].
- Both surgical and nonsurgical treatments of mallet finger injuries lead to excellent clinical outcomes [4].
- A dorsal glued splint is proposed for the treatment of all cases of mallet finger except stage IV injuries [5].
- A simple splint is recommended as an alternative means of treating mallet finger [8].
- Supplemental night splinting does not improve the outcome of mallet finger in terms of extensor lag, disability, or satisfaction with treatment [15].
- A hand therapist can treat type 1 mallet finger injuries as effectively as a surgeon [16].
- A hand therapist can treat type 1 mallet finger injuries as effectively as a surgeon, with a method of immobilisation that offers practically no complications regarding skin condition [39].
- Conservative therapeutic management of acute, closed mallet finger is diverse and varied, with exercises and interventions supplementary to splinting commonly utilised [23].
- An alternative simple and custom-made orthosis manages the mallet finger by allowing for PIP flexion while inhibiting full extension or hyperextension [25].
- The clinical efficacy of elastic taping for the treatment of mallet finger injuries remains to be tested vigorously [32].
Operative Management
- Surgery is occasionally recommended for acute or chronic mallet cases or for salvage of failed prior treatment [3].
- Surgical management may be considered for acute and chronic mallet lesions in patients who have failed nonsurgical treatment [10].
- Surgical management may be considered for acute and chronic mallet lesions in patients who are unable to work with the splint in position [10].
- Surgical management may be considered for acute and chronic mallet lesions in patients who have a fracture involving more than one third of the joint surface [10].
- Surgery is generally indicated in the case of mallet fractures involving more than one-third of the articular surface [9].
- Surgery is generally indicated in all patients who develop volar subluxation of the distal phalanx [9].
- A significant advantage of surgical management even in complicated cases (fracture >1/3 articular surface or volar subluxation) has yet to be clearly proven [9].
- Complication rates for conservative management of Doyle type 4c mallet finger are low, suggesting large-fragment cases can be effectively managed conservatively [2].
- Absolute indications for surgical intervention for mallet fingers in the pediatric population remain unclear [1].
Surgical Techniques
- The Thompson procedure is an effective technique for the salvage of a closed mallet injury with an associated swan neck deformity following failed treatment [27].
- A deepithelialised pedicled skin flap technique is a new reliable alternative in the treatment of chronic mallet finger [11].
- Scar overlapping suture for treating chronic tendinous mallet finger in children is safe and effective [36].
- For chronic mallet finger, if the distal phalanx droops severely but passive extension in the distal interphalangeal joint is still satisfactory, surgery may be indicated depending on the patient’s needs [14].
- Surgical treatment for chronic mallet finger involves making a small V-shaped or U-shaped incision on the dorsum of the finger, convex distally, with the tip no closer than 5 mm proximal to the nail base [14].
- The surgical technique for chronic mallet finger involves developing a flap between the tendon and subcutaneous fat to expose the extensor tendon with intervening scar [14].
- The surgical technique for chronic mallet finger involves identifying the junction of normal tendon with scar, severing the tendon transversely proximal to the joint, and resecting sufficient scar or tendon to allow closure with the finger in maximal extension [14].
- The surgical repair of chronic mallet finger is supported by a transarticular 0.045-inch Kirschner wire [14].
- The extensor tendon in chronic mallet finger surgery is repaired with 4-0 monofilament nylon or 4-0 monofilament wire as a pull-out roll stitch [14].
- Postoperative care for chronic mallet finger surgery involves removing sutures at 10 to 14 days and maintaining the distal joint in extension with Kirschner wire protection for 4 weeks [14].
- The Kirschner wire is removed after 4 to 6 weeks in chronic mallet finger surgery, with the repair protected by a splint for an additional 8 weeks [14].
Complications
- Absolute indications for surgical intervention for mallet fingers in pediatric populations remain unclear [1].
- Complication rates for conservative management of Doyle type 4c mallet fingers are low [2].
- Surgery is occasionally recommended for acute or chronic cases or for salvage of failed prior treatment [3].
- Both surgical and nonsurgical treatments of mallet finger injuries lead to excellent clinical outcomes [4].
- Stage IV mallet finger is treated with extra-articular pinning rather than dorsal glued splinting [5].
- Approximately 50% of patients with a mallet fracture involving more than one-third of the articular surface of the distal phalanx do not progress to subluxation of the DIP joint [6].
- Fracture size is an independent risk factor for the development of DIP joint subluxation in mallet fracture [6].
- Time to application of finger immobilizer is an independent risk factor for the development of DIP joint subluxation in mallet fracture [6].
- Pullout wire fixation together with distal interphalangeal joint Kirschner wire stabilization for acute combined tendon and bone mallet finger injuries reports no complications such as infection, nonunion, or nail deformity [13].
- Supplemental night splinting does not improve outcomes in terms of extensor lag, disability, or satisfaction with treatment [15].
- Full correction of extensor lag is less consistent with greater degrees of preoperative flexion deformity in severe chronic mallet fingers treated with central slip tenotomy and distal repair [18].
- The Thompson procedure is an effective technique for the salvage of a closed mallet injury with an associated swan neck deformity following failed treatment [27].
- The most common cause of procedural failure in closed reductions using an extension-block pin for bony mallet finger is inaccurate insertion of the K-wire to fix the distal interphalangeal joint [56].
Recovery
- Most mallet finger injuries can be managed non-surgically with splinting [3].
- Surgery is occasionally recommended for acute or chronic cases or for salvage of failed prior treatment [3].
- Both surgical and nonsurgical treatments of mallet finger injuries lead to excellent clinical outcomes [4].
- Complication rates for conservative management of large-fragment mallet finger cases are low [2].
- Supplemental night splinting does not improve the outcome of mallet finger in terms of extensor lag, disability, or satisfaction with treatment [15].
- LIPUS therapy may be recommended as an option to treat type I mallet finger fracture in children for whom initiation of treatment was delayed up to 8 weeks [29].
- Approximately 50% of patients with a mallet fracture involving more than one-third of the articular surface of the distal phalanx do not progress to subluxation of the DIP joint [6].
- Fracture size and time to application of finger immobilizer are independent risk factors for the development of DIP joint subluxation in mallet fracture [6].
- Full correction of extensor lag is less consistent with greater degrees of preoperative flexion deformity in severe chronic mallet fingers treated with central slip tenotomy with distal repair [18].
- The surgical technique of pullout wire fixation together with distal interphalangeal joint Kirschner wire stabilization for acute combined tendon and bone mallet finger injuries reports good to excellent long-term results [13].
- No reported complications such as infection, nonunion, or nail deformity were observed in the series of acute combined tendon and bone mallet finger injuries treated with pullout wire fixation and DIP joint Kirschner wire stabilization [13].
Key Evidence
- [L4] Absolute indications for surgical intervention for mallet fingers in this population remain unclear. [1] (10.1016/j.jhsa.2018.03.037)
- [L4] Complication rates were low, suggesting that large-fragment mallet finger cases can be effectively managed conservatively. [2] (10.1186/s12891-026-09787-w)
- [L5] Most mallet finger injuries can be managed non-surgically with splinting, although surgery is occasionally recommended for acute or chronic cases or for salvage of failed prior treatment. [3] (10.1007/s11552-014-9609-y)
- [L4] Both surgical and nonsurgical treatments of mallet finger injuries lead to excellent clinical outcomes. [4] (10.1016/j.jhsa.2017.10.004)
- [L5] The authors propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which they treat with extra-articular pinning. [5] (10.5999/aps.2016.43.2.134)
- [L2] Approximately 50% of patients with a mallet fracture involving more than one-third of the articular surface of the distal phalanx do not progress to subluxation of the DIP joint; fracture size and time to application of finger immobilizer are independent risk factors for the development of DIP joint subluxation in mallet fracture. [6] (10.1177/1753193414554556)
- [L2] The study recommends this splint as an alternative means of treating mallet finger. [8] (10.1136/emj.10.3.244)
- [L4] Although surgery is generally indicated in the case of mallet fractures involving more than one-third of the articular surface as well as in all patients who develop volar subluxation of the distal phalanx, a significant advantage of surgical management even in those complicated cases has yet to be clearly proven. [9] (10.1177/1558944716642763)
- [L5] Surgical management may be considered for acute and chronic mallet lesions in patients who have failed nonsurgical treatment, are unable to work with the splint in position, or have a fracture involving more than one third of the joint surface. [10] (10.5435/00124635-200509000-00007)
- [Paper] This method seems to be a new reliable alternative in the treatment of chronic mallet finger. [11] (10.1016/j.injury.2013.01.013)
- [L5] The majority of hand fractures can be treated without surgery, though surgery offers distinct advantages in properly selected cases. [12] (10.1016/j.jhsa.2013.02.017)
- [L4] The study describes a surgical technique for acute combined tendon and bone mallet fingers and reports good to excellent long-term results with no reported complications such as infection, nonunion, or nail deformity in the series. [13] (10.1016/j.jhsa.2014.11.011)
- [L1] Supplemental night splinting does not improve the outcome of mallet finger in terms of extensor lag, disability, or satisfaction with treatment. [15] (10.1007/s11552-013-9600-z)
- [L4] A hand therapist can treat mallet finger injuries of type 1 as effectively as a surgeon, with a method of immobilisation that offers practically no complications regarding skin condition. [16] (10.1177/175899830501000103)
- [L4] The article describes a technique combining central slip tenotomy with distal repair for severe chronic mallet fingers with deformities exceeding 36 degrees, noting that full correction of extensor lag is less consistent with greater degrees of preoperative flexion deformity. [18] (10.1016/j.jhsa.2014.01.040)
- [L4] This case raises a question regarding the possible role of biochemical abnormalities causing mallet fingers. [21] (10.1177/175899830400900103)
- [L4] Conservative therapeutic management of acute, closed mallet finger is diverse and varied, with exercises and interventions supplementary to splinting commonly utilised. [23] (10.1177/1758998316664822)
- [L5] An alternative simple and custom-made orthosis has been presented to manage the mallet finger, allowing for PIP flexion while inhibiting full extension or hyperextension. [25] (10.1016/j.jht.2016.01.001)
- [L4] The authors describe a rare combination of tendon avulsion and fracture in a juvenile mallet finger, noting that while few mallet fingers require open treatment, this combined injury may be more common than thought. [26] (10.1177/1753193415571777)
- [L4] It is an effective technique for the salvage of a closed mallet injury with an associated swan neck deformity following failed treatment. [27] (10.1016/j.jhsa.2013.04.011)
- [L3] LIPUS therapy may be recommended as an option to treat type I mallet finger fracture in children for whom initiation of treatment was delayed up to 8 weeks. [29] (10.1177/1558944717692095)
- [L4] The clinical efficacy of the proposed method of elastic taping for the treatment of mallet finger injuries remains to be tested vigorously. [32] (10.1016/j.jht.2014.02.005)
- [L5] Injuries to the finger extensor apparatus are very common and may produce chronic deformity and loss of function. [34] (10.1016/j.hcl.2013.03.003)
- [L4] This article provides a topical review of the contemporary literature concerning acute mallet finger injuries and proposes a modification to the Doyle classification to make it more encompassing and less prone to interobserver error. [35] (10.1016/j.jhsa.2022.10.013)
- [L4] Scar overlapping suture for treating chronic tendinous mallet finger in children is safe and effective. [36] (10.1186/s13018-019-1106-0)
- [L4] A hand therapist can treat type 1 mallet finger injuries as effectively as a surgeon. [39] (10.1197/j.jht.2008.04.002)
- [L4] The interrater reliability of the Kellgren & Lawrence and OARSI classification systems for post-traumatic osteoarthritis in the distal interphalangeal joint after mallet finger fractures is considerably lower than initially assumed. [41] (10.1016/j.jhsa.2024.03.012)
- [L3] Non-operative management of mallet fractures, regardless of fracture classification, joint congruence or pre-existing degenerate change in the DIP joint, is safe and yields predictably good outcomes in most patients. [46] (10.1177/1753193421992986)
- [L5] Most acute mallet fingers can be treated by continuous splinting, while fracture dislocations require open reduction and internal fixation. [50] (10.1097/01.blo.0000205903.51727.62)
- [L4] The extension block technique, when properly applied, produces satisfactory results and is effective and minimally invasive for mallet finger fractures. [54] (10.1054/jhsb.2001.0733)
- [Paper] The most common cause of procedural failure was inaccurate insertion of the K-wire to fix the distal interphalangeal joint. [56] (10.1055/s-0040-1701318)
References
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