Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Dropped finger ++ 736.1 Mallet finger ++ M20.019 Mallet finger of unspecified finger(s) ++ 4E: Impaired joint mobility, motor function, muscle performance, and ROM associated with localized inflammation1 +++ Description ++ Distal joint of the finger is bent into a claw like positionUsually due to trauma from impact on tip of the finger2Flexor muscles, fascia, tendons shortenDisruption of the extensor tendon, 15 to 20 degree loss of DIP finger extensionFlexion of the distal interphalangeal joint (DIP) +++ Essentials of Diagnosis ++ Diagnosis is usually made by clinical examination or x-rayAssses finger extension strength, often extensor digitorum communis injury +++ General Considerations ++ SwellingInflammation around the jointCan be associated with fracture, children type IV epiphyseal fracture3Altered joint position +++ Demographics ++ AdultsHit or blow onto the finger, often from playing basketball3 +++ Signs and Symptoms ++ Pain with graspingDecreased extension of the fingerJoint redness and pain +++ Functional Implications ++ Pain with grasping, holding objectsInability to extend the finger +++ Possible Contributing Causes ++ Muscle imbalanceExtensor digitorum communis injuryTraumaJoint arthritis/injuryMuscle atrophyNerve damageOsteoarthritisRheumatoid arthritis +++ Differential Diagnosis ++ GoutBoutonniere deformityStress fracture +++ Imaging ++ X-ray ++ Bone spur, location and size +++ Medication ++ Anti-inflammatory +++ Medical Procedures ++ Surgery to straighten out the finger and lengthen ligaments/tendons ++ For imaging, x-rayFor corticosteroid injectionFor surgical consult ++ Pain with grasping objects for work and daily activities ++ Rest, to reduce inflammationBracing/splintingTaping techniquesAddress swelling and painIceAddress painIceMassageJoint mobilizationElectric stimulationIontophoresisInfraredAddress weakness and joint instabilityStrengthening of extensorsAddress lack of flexibilityStretchingIntrinsic flexor stretchingFluidotherapyAddress joint mobilizationDIP glides & rotationAddress soft tissue mobilization ++ Patient will be able to grasp and hold a shovel for gardening ++ Good; focus on stretching out the flexorsSurgery may be indicated if the flexion becomes severeIf 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... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.