175: MALLET FINGER

CONDITION/SYNONYMS

• Baseball finger

• Dropped finger

ICD-9-CM CODE

• 736.1 Mallet finger

ICD-10-CM CODE

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

PREFERRED PRACTICE PATTERN

• 4E: Impaired joint mobility, motor function, muscle performance, and ROM associated with localized inflammation¹

KEY FEATURES

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 DIP joint

Essentials of Diagnosis

• Diagnosis is usually made by clinical examination or x-ray

• 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 tip from sports, i.e., basketball³

CLINICAL FINDINGS

Functional Implications

• Pain with grasping, holding objects

• Inability to extend the finger

• At risk of injury in factories as finger not in alignment with the others and can get caught or injured

Possible Contributing Causes

• Muscle imbalance

• Extensor digitorum communis injury

• Trauma

• Joint arthritis/injury

• Muscle atrophy

• Nerve damage

• Osteoarthritis

• Rheumatoid arthritis

Differential Diagnosis

• Gout

• Boutonnière deformity

• Stress fracture

MEANS OF CONFIRMATION

• Imaging

  • X-ray

FINDINGS ...