Skip to Main Content

++

  • Dropped finger

++

  • 736.1 Mallet finger

++

  • M20.019 Mallet finger of unspecified finger(s)

++
++

Description

++

  • Distal joint of the finger is bent into a claw like position
  • Usually due to trauma from impact on tip of the finger2
  • Flexor muscles, fascia, tendons shorten
  • Disruption of the extensor tendon, 15 to 20 degree loss of DIP finger extension
  • Flexion of the distal interphalangeal joint (DIP)

++

Essentials of Diagnosis

++

  • Diagnosis is usually made by clinical examination or x-ray
  • Assses finger extension strength, often extensor digitorum communis injury

++

General Considerations

++

  • Swelling
  • Inflammation around the joint
  • Can be associated with fracture, children type IV epiphyseal fracture3
  • Altered joint position

++

Demographics

++

  • Adults
    • Hit or blow onto the finger, often from playing basketball3

++

Signs and Symptoms

++

  • Pain with grasping
  • Decreased extension of the finger
  • Joint redness and pain

++

Functional Implications

++

  • Pain with grasping, holding objects
  • Inability to extend the finger

++

Possible Contributing Causes

++

  • Muscle imbalance
  • Extensor digitorum communis injury
  • Trauma
  • Joint arthritis/injury
  • Muscle atrophy
  • Nerve damage
  • Osteoarthritis
  • Rheumatoid arthritis

++

Differential Diagnosis

++

  • Gout
  • Boutonniere deformity
  • Stress fracture

++

Imaging

++ ++

  • Bone spur, location and size

++

Medication

++

  • Anti-inflammatory

++

Medical Procedures

++

  • Surgery to straighten out the finger and lengthen ligaments/tendons

++

  • For imaging, x-ray
  • For corticosteroid injection
  • For surgical consult

++

  • Pain with grasping objects for work and daily activities

++

  • Rest, to reduce inflammation
  • Bracing/splinting
  • Taping techniques
  • Address swelling and pain
  • Address pain
  • Address weakness and joint instability
    • Strengthening of extensors
  • Address lack of flexibility
  • Address joint mobilization
    • DIP glides & rotation
  • Address soft tissue mobilization

++

  • Patient will be able to grasp and hold a shovel for gardening

++

  • Good; focus on stretching out the flexors
  • Surgery may be indicated if the flexion becomes severe
  • If associated with fragment fracture, one to six weeks of immobilization

1. The American Physical Therapy Association. Pattern 4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated With Localized Inflammation. Interactive Guide to Physical Therapist Practice. The American Physical Therapy Association. 2003. http://guidetoptpractice.apta.org/content/1/SEC12.extract?sid=ccb92104-9626-443e-ab17-b2a32a7792b7. [DOI: 10.2522/ptguide.978-1-931369-64-0]. Accessed March 1, 2012.
2. Dutton M. Musculoskeletal Physical Therapy. In: Dutton M, ed. McGraw-Hill's NPTE (National Physical Therapy Examination). 2nd ed. New York, NY: McGraw-Hill; 2012. http://www.accessphysiotherapy.com/content/56504934. Accessed November 11, ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.