Mallet Finger

What is a Mallet Finger?

The quick answer is that a mallet finger deformity occurs when there is an injury to the terminal extensor tendon on the top of the finger or thumb that is responsible for extending or straightening the tip of your finger.


This injury commonly occurs in athletes and individuals participating in various sports where the tip of the finger is jammed or hit with a ball causing the tip of the finger to bend down forcibly. 

A Mallet finger can also be caused by cutting the tendon while preparing food in the kitchen or being crushed while performing job-related tasks. In some cases a fragment of bone can also detach along with the tendon also known as an avulsion fracture.

Symptoms of Mallet Finger

An injury to the finger or thumb can cause the terminal tendon to tear or rupture, preventing the patient from straightening the tip of their finger on their own power while still being able to move it with assistance. 

A mallet finger deformity presents with the tip of the finger in a “drooped” position. Swelling, pain, redness and bruising may also be associated with mallet finger limiting ROM, strength and functional use of the effected hand for self-care, homemaking, and recreational activities.

Mallet Finger Treatments

Seeking medical attention as soon as possible is recommended for achieving favorable outcomes and to properly diagnose and treat the injury. A formal evaluation and assessment should be performed by an upper extremity orthopedic physician who will perform a physical assessment and obtain x-rays to accurately diagnose the injury, determine the severity of the injury, as well as if there is an associated fracture. 

Typically treatment consists of fabricating an orthosis or splint to keep the tip of the finger extended (straight) for at least 6 to 8 weeks to allow the tendon to heal. The individual wears the orthosis at all times being careful to not let the finger droop at all during that time frame which can delay the healing process. 

Surgical intervention is usually not necessary, however in some cases with significant fracture fragments or if the joint is misaligned, surgery is indicated and pins are used to stabilize the fracture as it heals. Non-steroidal anti-inflammatory medications, elevation, ice and heat can all be used in conjunction with splint wear to manage inflammation, swelling, pain, and stiffness following a mallet finger injury. 

In some cases, the orthopedic physician may prescribe occupational therapy to maximize ROM and strength of the effected finger to allow the individual to return to their prior level of function with activities of daily living and sports. 

The occupational or hand therapist will instruct the individual on proper splint wear and will also provide exercises to maintain or increase motion in the middle joint to prevent the finger from becoming stiff. 

Modalities can also be utilized for swelling and pain management. Once the mallet finger has fully healed, the hand therapist will provide a home exercise program to regain functional motion and strength in the fingertip.

To learn more about hand injuries, please go to: Hand and Wrist Video

To schedule an appointment for physical therapy at one of the 12 JOI Rehab Centers, please call 904-858-7045.  We can also come to your home with the JOI Rehab Bridge Program.

Make an appointment for a fracture or similar injury by calling (904)JOI-2000 or click below.

By: Julia Guthart, OT, CHT



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