Basildon EM Handbook 2018

Mallet finger

March 2018 | by EMauthor

•Not to be confused with trigger finger

•Forced flexion to the extended finger causes the injury, resulting in tear of the distal extensor tendon slip to the terminal phalanx with or without bone avulsion. It can happen with trivial trauma

•There will be drooping of distal phalanx with inability to fully extend it. Pain and or tenderness are often absent

•X-ray finger to exclude or assess the size of avulsed bone fragment

•Ligamentous injuries or those with small avulsion (the vast majority) can be treated with Mallet splint which fixes the DIP joint and allow free movement at the PIP joint

•Large avulsion involving more than 20% of articular surface may be considered for surgery, refer to orthopaedics

•Arrange fracture clinic follow up to all patients

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