Condition guide
Did a ball hit your fingertip, or did you stub your finger hard, and now the tip droops and you cannot straighten it on your own? The tendon that straightens the end joint may have torn, or come away from where it attaches together with a small piece of bone. Treatment is usually simple but needs patience: the fingertip is kept straight in a splint for weeks, without ever bending.
An X-ray shows whether a piece of bone has come away, and treatment depends on this. So see a doctor soon after the injury.
Skin that stays wet under the splint gets sore very quickly. Keep your finger and the splint dry, and do not cover the splint’s ventilation holes with tape. Someone can help you with these steps.
Exercises at home
Do the first exercise while wearing the splint. Start the other three when the continuous splinting period (6 or 8 weeks) has ended and your team agrees; during this time, keep wearing the splint for another 2–4 weeks at night and for heavy or risky tasks. If your fingertip starts to droop again while exercising, stop, wear the splint all the time and contact your team.
Without removing the splint, fully bend and straighten the middle joint of your injured finger; the end joint stays straight inside the splint. Move your other fingers fully too, so they do not get stiff.
10 repetitions, 3–4 times a dayStart after the continuous splinting period has ended. Straighten your fingers and thumb as far as you can and spread them apart.
Hold for 10–20 seconds, little and oftenKeeping the knuckles at the base of your fingers straight, bend only the middle and end joints, then straighten your fingers. Stop if the end joint starts to droop.
10–15 repetitions, 4 times a daySlowly make a full fist, then open your fingers completely. Your finger may feel stiff at first; work little and often without forcing it.
10–15 repetitions, 4 times a dayUsually not; most mallet fingers do well with a splint alone. Surgery may be needed if a large piece of bone has come away with the tendon. It is usually a day-case procedure under local anaesthetic, fixed with fine wires that stay in for 3–4 weeks.
During the continuous splinting period, even a single bend of the end joint can damage the healing tendon and delay healing; the splinting period often starts again from the beginning. Only take the splint off for cleaning, with your finger resting flat on a table. If this has happened, tell your team.
It recovers well for most people, but even with the best treatment a lag of up to 10 degrees at the end joint is common. Swelling, tenderness and redness over the back of the finger can take a few months to settle. When a piece of bone came away, a small bump may remain over the joint; this usually does not affect how the hand works.
You can drive when you can grip the steering wheel firmly without pain distracting you; check with your insurer about driving with a splint. One NHS leaflet advises avoiding sport for at least 8 weeks; decide when to return with your team.
The finger may swell, and a ring can affect blood flow and healing. Do not wear a ring on the injured finger while you are in the splint.
For a finger that catches or locks, see the trigger finger guide; for pain and stiffness in the finger joints, see the hand and finger osteoarthritis guide.
Sources
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