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Mallet finger DiscussionMallet finger injury usually represents mechanical failure of the terminal digital extensor mechanism, either from tendon disruption or fracture. Mallet injuries may be classified as follows:I. Closed tendon rupture II. Laceration a. Without joint surface injury b. With joint surface injury III. Abrasion with tissue loss IV. With fracture a. Without joint subluxation b. With joint subluxation Treatment is individualized and involves either conservative treatment with continuous extension splinting or surgical repair and pinning. Splinting must be continuous to be effective. Surgery has risks of infection, hardware problems, stiffness, wound healing problems and technical failure, among other possible complications. Regardless of treatment, some permanent visible loss of both flexion and extension is expected. Persistent deformity is more likely to be obvious in fingers with hyperextensible proximal interphalangeal joints or absent a superficialis tendons. Despite this, functional recovery is usually satisfactory. Deformity persisting over three months is unlikely to improve with splinting alone. No current treatment can be expected to improve active range of motion for a chronic deformity, and treatment options are generally limited to joint fusion, tenodermodesis, or doing nothing further.
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