Ask Dr. Geier – Mallet Finger

As those people who follow me on Twitter saw, I stayed up late watching the Super Bowl last night. I tweeted about all of the injuries that occurred, and I will try to find out more information so that I can explain the injuries here. For those of you who don’t follow me on Twitter, please check it out. If you like explanations of injuries during pro and college games or articles from a variety of sports medicine experts I follow, then you might enjoy my tweets.

From my year spent with the St. Louis Rams, I will say that hand injuries can and do occur in football. At that time at least, the Rams even had a hand surgeon as one of their orthopaedic surgeons. Today’s Ask Dr. Geier column addresses a fairly common hand injury in sports. As always, please refer to my disclaimer for giving specific medical advice via email or online.

David

Yvonne in Chapel Hill, NC asks:

I just injured my right middle finger 2 days ago and went to Urgent Care where I was diagnosed with a mallet finger. They put my finger in a splint. I understand that I need to keep the finger straight for the next 6-8 weeks. The finger does not hurt at all. I am an avid recreational tennis player (usually play 3-4 times per week). If I make sure the splint is securely on, can I still try to play tennis?

Let me start by saying that I typically send patients with hand and finger injuries, even if the injury occurred in sports, to one of my partners who specializes in hand surgery. Having said that, I feel comfortable discussing the basic principles of diagnosis and treatment of a mallet finger.

A mallet finger typically occurs when an object such as a ball strikes an athlete on the tip of one of the fingers, flexing the fingertip down. This injury can rupture the tendon that extends the tip of the finger. He or she will notice that the fingertip is bent down in a flexed position and that he or she cannot fully extend it. I do think that it’s important for an athlete with this type of injury to seek evaluation by a hand specialist within the first few days. While diagnosis is usually straightforward, it is important to rule out a fracture. X-rays will be obtained to ensure a fracture did not occur at the time of the injury, as a large fracture or a fracture with multiple small pieces might need surgical treatment.

A splint that will keep the tip of the finger extended, especially if it allows the finger to bend at other joints, can be used to help a mallet finger heal..

Typically the treatment for a mallet finger is an extension splint such as what the reader mentions above. The splint we’ll keep the finger extended to help the extensor tendon heal appropriately. It is important to know that the splint must be worn all the time. If he or she removes it and the fingertip flexes down, it could rupture the healing tendon. In this case the patient might have to start wearing the splint again, and the length of time will start over. The splint is worn approximately 6-8 weeks and then gradually worn less and less.

Occasionally surgery is needed to treat a mallet finger. Injuries that involve fractures, especially comminuted fractures, or tendon injuries that fail to heal might be good candidates for surgery.

As far as trying to play in a splint, it really depends on the type of sport or activity that the athlete is trying to perform. If the splint can be kept on the fingertip and can keep it extended, it might be possible to play. If there is any question about the ability to wear the splint, I would urge caution and try to get the injury to heal as quickly as possible. Again consultation with a hand surgeon to help make the decision about returning to sports is usually a good idea.

117 Responses to Ask Dr. Geier – Mallet Finger

  1. [...] This post was mentioned on Twitter by Tony Ciuffo, David Geier. David Geier said: New Ask Dr. Geier Monday column: Mallet finger http://www.drdavidgeier.com/?p=1376 #hand #injuries [...]

  2. Snuffles says:

    Hello Dr Geier,

    I am writing to ask you question, about your reading about “Mallet finger Injuries” as I recent busted up me thumb and now the tip droops down. I went to hospital and had a x-ray and they was not fracture,phew!

    How effective is the “stack” splint in healing thumbs? As it’s the first time I have ever busted a finger to this extent, I got to it early so will it recover fully? As the nails have turn a nasty purple,and yellowish color and what do I with it to make it better?

    • drdavidgeier says:

      That splint works well for mallet fingers if it fits properly and the patient wears it continually. If the tendon heals properly, patients can usually expect fully function.

  3. Stacy says:

    Hello Dr. Geier,
    My 11 y/o son has mallet finger from playing football and has been placed in a stack splint for 8 weeks. The Dr. said he recommended against continuing to play for the rest of the season. Is there anything safe to use to place on his finger on top of the splint to allow him to continue during the season? He is a starting defensive player.
    Thanks for your input.

    • drdavidgeier says:

      Athletes can pad splints to protect themselves and other players from injury with the splint. The problem that many football players have with finger splints is that they can’t grip anything because the splint does not allow that joint to bend. In theory, players at certain positions shouldn’t need to grip balls, jerseys, etc., but those splints can still make it difficult to play. Plus, the joint injured has to stay completely straight when the athlete plays. If it bends, the healing tendon can stretch back out.

  4. Ben says:

    Hello Dr. Geier,

    Last week I got mallet finger from catching a football. I went to the ER, and the ER doctor said the x-rays showed no broken bones. My finger is in a splint and I’m seeing a Orthopedist in a few days for further diagnosis. To make matters more worse, I don’t have health insurance. If the tendon does heal, will the finger still be as strong as it was before the injury? Also, do you recommend any foods that help repair tendons? Right now I’m drinking pineapple juice.

    • drdavidgeier says:

      Mallet finer injuries typically have no lingering issues if they heal properly – full extension and strength. As for foods, I am not familiar with any foods, vitamins, or other supplements that would have much effect.

  5. Ben says:

    Hello again Dr. Geier,

    I visited a Ortho doctor a few days ago and he re splinted me and I have to wear it for 6 weeks. Before I was not having pain, but now I’m having tingling feeling in the finger? Also, my other fingers are feeling stiff from not being able to fully move the hand. Im not having any circulation problems. Is this part of the healing or should I consult my doctor?

    • drdavidgeier says:

      Stiffness is not uncommon with these injuries. Working with an occupational therapist or hand therapist can be helpful to restore full motion. Occasionally the splint can be too tight, causing some transient tingling, but seeing the hand surgeon can ensure there is no nerve damage.

  6. Snuffles says:

    Hello again Dr D Geier,

    I am wonder with my progress with my mallet thumb is I try to exercise the weaken tendon with squish ball after bathing and I have re-pack my band aid to hold the splint on ,plus clean it with a wet one as well as my finger as well and dry it properly.

    I use the squish ball to exercise the thumb area where it was injured, after a few repetitions I can feel that the tip of my thumb wants to drop again, so I put the splint as soon as I feel it and tape up again.

    is it normally for my thumb wanting to drop down again?Please explain.

    Thank You.

    snuffles.

    • drdavidgeier says:

      To be fair, as it says on this blog, I cannot give specific medical advice. I would recommend that you check with your doctor. Having said that, lack of extension could be continued weakness, a tendon that never healed, or a number of other possibilities. Your surgeon can examine your thumb and offer you more specific information. Thanks for the follow up!

  7. Snuffles says:

    Hello Dr David G,

    I had the splint on for a bit over six weeks on my mallet thumb and when changing the tape on before replace the splint I was using a squeeze ball to strengthen that thumb for quite a few weeks, after a few weeks.

    Then for first time for a while, over a month I removed the splint for at most 2 days. Then to my disgust I noticed only this morning the tip was drooping down, I cursed under my breath as I thought I did everything right in the medical book and what my dr said and my thumb has failed me again.

    Do you have any suggestions to make for me what to do next. As I am stumped for ideas….Only to keep the splint on and put up a stuffed thumb all my time or something, Any suggestions?

    Puzzled

    • drdavidgeier says:

      As I’ve said, I can’t really tell you what to do or what is going on since I haven’t examined you or treated you. I would suggest discussing it with your hand surgeon.

  8. Ben says:

    Hello again Dr D Geier,

    I visited my Orthopaedic doctor a few days ago for a follow up after being in a stack splint for 6+ weeks. My finger is now straight, which he believes has healed. However, the finger tip is so stiff from splinting that I cant bend it. He told me to continue wearing the splint for 2 more weeks, but take it off a few times each day and practice bending and straightening. After 2 weeks, wear the splint on only at night.

    I wish I would have asked him this at the time, but its now only come up. Is it best to stay in a stack splint or does it not matter? The reason I ask is because my stack splint requires tape, and its getting annoying having to take it off to practice and then re-tape it back up. Also, the stack splint is giving me skin peeling problems. I would much rather use a aluminum splint that can easily be taken off and put back on, is that ok?

  9. Terri says:

    I recently broke my right ring finger, bending it down. I wore a splint for 6 weeks, and the finger seemed to be healing well, although my dr said it was only about 80% healed. Two weeks after removing the splint, I rebroke the finger the same way…by bending it down. I was re-splinted for 3 weeks when I developed contact dermatitis and my dr removed the splint. he now says that surgery (pin for 6 weeks) is the only option for my “mallett” finger. any suggestions?

    • drdavidgeier says:

      I really can’t tell you too much without examining your finger. If a patient’s finger heals in a flexed position, a hand surgeon often has to use surgery to restore the position, and that can involve a pin in the bone. I might ask your surgeon about other options or get an opinion from another hand surgeon. Thanks for the question!

  10. Dave says:

    Hello Dr.
    I was diagnosed with mallet finger a few days ago. The Dr. taped a splint across the top of my finger. Since it is so vital that the finger stays straight, I am quite concerned when changing the bandage with this type of splint. Is there another type of splint I could consider? The one in the photo of the article looks like it would be much easier to change the bandage.
    Thank you.

    • drdavidgeier says:

      Brace shops that fit and sell braces, splints, and shoe orthotics have them. Physical therapy practices and hand therapists have them as well, but they might only have them for current patients. Hand surgeons usually have them in their practice as well, or they can recommend where to get them. Hope that helps!

  11. Robert says:

    Hi Dr. Geier,
    Appreciate you taking the time to read this. I have recently been treated for my second mallet finger in two years. My last injury was to the right middle finger (my dominant hand). Because of the stress the splinting caused me on my last mallet injury- I opted to have a k wire inserted for six weeks followed by an additional 4 with a splint. I have gone to therapy twice which worried me a great deal. Was so scared of a recurring droop. Now my finger has a slight 5 degree droop. My doctor says that it is “as good as gets”. But I have heard other opinions that i could resplint to get that last bit of healing. Although, I don’t know if the therapy already stretched the healing tendon out. Would resplinting even possibly help get rid of the extensor lag at this point?
    Thanks, for any feedback

    • drdavidgeier says:

      To be fair, I can’t help you too much because I am not a hand surgeon and because I haven’t examined you. Splinting typically works very well for primary mallet fingers, but I don’t know if it helps much after surgical fixation. In general I doubt there is much harm with splint the DIP joint to see if full extension can be regained, but it is hard for me to say in your case.

  12. lorenzo davis says:

    Hi Doc I have a mallet finger and I can’t afford to sit out playing basketball can I still play with it taped up.

    • drdavidgeier says:

      I have had basketball players play with a mallet finger in a splint or taped. The sport itself makes it difficult, in that dribbling and shotting can be challenging if the injury is on the dominant hand. Thanks for the question!

  13. Lyn says:

    I injured my finger on Dec 17th. (Mallet Finger) Starting splinting that day and then the Oval8 splint on Dec 21st. No swelling or pain until about 3 weeks into splinting. The splint felt like it was digging in the top of the last joint. Very Raw! Worse than that, just below my middle joint is swollen and very tender. Went to the Dr. on the Jan. 24th and he said to only wear the splint at night. I had to ordered another Oval8 online because I can not get the first one on anymore. It feels like a lentil bean just below the middle joint attached to kite string that funs down to the first joint.
    The finger dips just slightly. Not to bad. I can live with that. I tend to wear the splint more during the day because it starts aching so bad. I even take advil for the pain.
    Is this continued swelling and pain normal and part of the healing? OR Is it scar tissue? Should I not wear the splint at all during the day? I’m really scared of re-injury.
    Thank You so much!

    • drdavidgeier says:

      I’m sorry but I really can’t give your specific advice. I think I would ask your hand surgeon and get his advice. Thanks for reading!

  14. Whitney says:

    Hello Dr. Geier,

    Do you have any estimate of often surgery must be performed in instances where the mallet finger has only a single small amount of bone broken off with it?

    I’m waiting for my surgery consultation and was just curious how often surgery occurs in these instances. Because of the tight time window, they said I may have surgery immediately following my consultation if it is necessary, so I want to be mentally prepared if it is likely.

    Thanks for reading this! Also thanks for the very informative article!

    • drdavidgeier says:

      Honestly I can’t say without seeing it. In general, whether or not one of these injuries needs surgery depends on how large the bony fragment is.

      • Whitney says:

        Thanks for the input! I’m just being impatient since obviously I’ll know either way come Monday!

        I’m still in denial since it doesn’t hurt that badly, so I don’t understand how it can be so severe as needing over 2 months to heal!

        But this article definitely helped me understand everything a lot better!

        Thanks again!

  15. Dan says:

    Hi,
    I got malletfinger on my pinky two weeks ago during a soccer game when I played in net. It’s been splinted for the past 4 days and XRays have shown there is a small chip fracture. I am currently splinting with a popsicle sticks which seems to work better than any splints I have tried. My question is is it possible that I can play goalie next week or the week after with my splint on and my finger being taped up heavily? I’d hate to miss so many games

    • drdavidgeier says:

      As I’ve said many times on this thread, I really can’t give you specific medical advice. Your hand surgeon would be able to tell you the risks and benefits of playing better than I can since he has seen your injury. Also, I am answering a question much like this on my show this weekend.

  16. Bo says:

    Hi,
    I got a mallet middle finger yesterday playing basketball. Went to doctor immediately, who put finger in a stack splint for 8 weeks. My question: do you think is it OK to take finger out of splint every day or two for “fresh air” and to retape ? I think I can slide it out w.o bending the joint. Or, do you suggest sucking it up and only doing weekly or even less frequently ?

    thank you. ps- great blog site.

    • drdavidgeier says:

      In general, if patients can wash the finger and reapply the splint while keeping the finger fully extended, then there is little concern for rupturing the healing tendon. If there is a concern that the joint will flex, then keeping the splint on is typically the recommendation. Thanks. Glad you like the blog!

  17. Jenson says:

    Hi Dr. Geier,

    Thanks for all this helpful information in this site! I got a mallet finger on my pinky 6 weeks back. Consulted a doctor,x-ray revealed that a small chip of bone aslo came off. Doc said I don’t n need surgery as it is a minor fracture & I may have to use a splint from 1- 3 months & may even some more time. Since swelling is still there i am sure its not yet healed. I could not goto the same doc again & had to visit another doc last week & he suggested surgery would be better as it hasn’t healed much in 5 weeks. Based on what you may have seen with similar injuries will you be able to tell me what will be the risk I take if I just try full splinting for another 6 – 8 weeks instead of a surgery?

    When would it be safe to start bending the injured part. Is it recommended only after the swelling is completely gone?

    Thanks

    • drdavidgeier says:

      I really cannot give you a specific answer to your question, as I haven’t seen you as a patient or examined you or seen any radiographic studies. In general, when a hand surgeon allows a patient to bend the finger depends on when the tendon (or bone if the tendon pulled a piece of bone off as well) heals. X-rays every few weeks help the surgeon decide when that has occurred. When to say that a mallet finger hasn’t healed also can really only be answered by the surgeon treating it, but the big risk of continuing splinting for a mallet finger would mainly be that the patient’s tendon/bone might still not heal and he would need surgery at some point. Sorry I can’t answer more specifically.

  18. Collin says:

    Hi Dr. Geier,

    I just went to the doctor today for what I assume is mallet finger after looking at pictures for comparison, but my doctor said it was “only sprained” after looking at x-rays (no fractures!)

    Should I seek imaging to see if there’s damage to the tendon? When she tested it I had decent strength pushing down but I have the characteristic finger droop on my left ring finger.

    Thanks!

    • drdavidgeier says:

      I really cannot give you a specific answer to your question, as I haven’t seen you as a patient or examined you or seen any radiographic studies. In general, one key test would be whether or not the patient can extend the fingertip by himself. Also, a large percentage of mallet finger injuries are not bony injuries but rather just involve avulsion of the tendon.

      • Collin says:

        Thanks…two more questions, and if you can’t answer that’s fine (I’ll probably head back in for a second opinion this week)

        1. My finger tip isn’t *completely* bent over like most photos of the injury, only slightly. It also feels a lot better after what I think was also a jam to the knuckle closest to my hand has gotten better.

        2. I’ve been self-treating so far with a simple comfort splint I purchased from CVS — it does a good job of keeping my finger straight. Is this sufficient, or should I curve the splint to curve the tip of my finger up?

        Thanks so much. I’m really glad to have found your site.

  19. Tim says:

    Hello Dr. Geier,
    I suffered a mallet finger injury yesterday on my left ring finger when playing in a baseball game, I jammed it running into the first baseman, I really felt no pain and didn’t realize it drooped down until I got back to the dugout after the inning, then it felt somewhat numb and I realized I have a lack of control of the finger tip and not the proper sensation in it. I don’t want to miss the remainder of our season, which will be over in six weeks or so. Can I wear a splint at all times with the exception of taking it off for my games (about three games per week)? I’m aware of the recommendation that the splint should remain on for 6-8 weeks continuously however I’m wondering if there is any merit to the idea of wearing except for games, then when the season is over wearing it for six consecutive weeks at that time. I’m not sure how to handle the situation, your thoughts would be helpful. Thank you.

    • drdavidgeier says:

      I really cannot give you a specific answer to your question, as I haven’t seen you as a patient or examined you or seen any radiographic studies. I think that the idea of essentially waiting for six weeks before truly beginning the splinting process would be debated by hand surgeons. It is hard to know if the tendon would be less likely to heal with a significant delay.

  20. Mike says:

    I injured my finger on June 9th, (mallet finger) playing basketball. I have had a splint on since the day it happened. Going on my 4th week this weekend. Finger has been straight in a splint for the whole time. Is it ok to take it off and test the finger or should i actually hold out and wait the six weeks. Oh and the x-rays showed no fractures or broken bones just the tendon snapped. Your opinion please.

  21. Addison says:

    Hi i injured my finger tucking in couch sheets… and im pretty sure i have mallet finger as it droops down i have got a splint on but i have taken in off for a few seconds to look at it… it still droops down and i have not been to the doctor bcuz my parents don’t think its necessary..ive been wearing the splint since the 3rd of july and its drooped and sleightly bent to the right… i just wanted your opinion

    thank you so much, addison

    • drdavidgeier says:

      Seeing a hand surgeon and finding out the extent of the injury might be appropriate to better direct the treatment plan.

  22. Kevin says:

    I just finished the healing process for mallet finger, was in a splint for 8 weeks, the doctor says I don’t need to wear it anymore and do not need to return. My question is, since the finger is so stiff due to splinting, can I apply normal strength to gripping as I would have previously, I can’t grip a golf club anymore and was wondering if there is any risk to forcing harder to be able to wrap my finger around a club, or is there an increased risk of reinjury

    • drdavidgeier says:

      I would check with your surgeon for specific advice and restrictions, as I can’t give you information without examining your finger and any necessary studies. Having said that, if mallet finger injuries completely heal, then there are usually no restrictions on activity.

  23. Karen says:

    My son injured his finger yesterday and was diagnosed with mallet finger. We were given the option of splinting for 8 weeks or opting for surgery to put a pin in. We were told that with the surgical option, he would be able to play baseball while the pin is in. In all of the posts above, I have not seen where the patient was given the option. It seems that most of the time it is splinted. He does have a broken bone fragment, but the break was not given much concern when the options were presented by the doctor. I was not prepared for surgery as a choice so quickly. I have noticed some of the above posts inquire if they can continue sports with a splint, however, you did not mention that they should inquire about the pin instead so that they may continue sports. Am I misunderstanding the situation? Will it be a while for sports even with the pin? We chose the surgery figuring that it would be better since there is less chance that he would accidently bend the finger and have to restart the healing. Additionally, it would allow for him to continue his activities. Is this normal to have surgery be an “option” ? Can you offer advice as far as issues that we may not be considering regarding the surgical choice and the recovery after the pin is removed. Thank you for your thoughts and time.

    • drdavidgeier says:

      I really cannot give you a specific answer to your question, as I haven’t seen him as a patient or examined him or seen any radiographic studies. I would follow whatever restrictions are outlined by your surgeon. Many hand surgeons will not allow sports while a pin is in place as they are waiting for the injury/surgery to heal and to avoid the possibility of breaking the pin in the finger.

  24. srikanth says:

    I had a mallet finger surgery 6 weeks back and my pins were removed just yesterday. Still i see the swelling on finger and the slight pain . Is there a recovery time after the pins are removed.

  25. Sarah says:

    Hi Dr. Geier,

    I fractured my pinky on 9/17 while on vacation in the Bahamas. I sought treatment for it when I returned to Florida and was told that I have a mallet fracture, treatment to consist of a constant 8 weeks of hyper-extended (up) splinting. I was told if my finger droops for even a second it could disrupt my therapy and healing so I have been very careful while changing my splint or re-taping it, constantly holding the tip of my pinky up while this takes place. The splint has been on for a week and pretty much all my pain is gone, but last night my boyfriend was having a hard time re-splinting and taping it and while I was holing my pinky tip up he was trying to push the bottom of my pinky against the splint to tape and he accidently made the joint bend slightly in the direction of the droop….. definitely not what we want happening! It didn’t hurt I just saw it take place. Now I am afraid that I will have to start all over and this last week of pain in the butt splinting has been lost because of this one mishap :( Do you think it will be okay and continue to heal? Do you think this disrupted my treatment and healing? I see my hand ortho in 8 days for a f/u but I’m just so worried. I just want my non-deformed normal pinky back! Thanks Doc :)

    • drdavidgeier says:

      Sarah, it is really hard to give you an answer as I haven’t seen you and examined your finger. I think seeing your orthopaedic surgeon is a good idea. Until that point, patients generally can try to do everything they can to keep the finger splinted in extension to maximize the chances of healing. Whether one short period of flexing that joint can reinjure the healing tendon is hard to say without an exam. Hope that helps!

  26. Mort says:

    Dr. Geier,
    This may sound like a strange question, but are there any cases where you can see an amputation as being a reasonable course of action? Thank you.

  27. Gabe says:

    Is it common to have sharp pain late in the healing process? I have has my splint on for 7 weeks. About twice a day my finger involuntarily twitches and I have sharp stinging pain for about 10 to 15 seconds. Then I feel no residual pain. I am wondering if this is likely just stiffness or sign of something wrong.

  28. Mark says:

    Great comments above. Glad I found this sight.

    I suffered a mallet finger 4 weeks ago playing basketball. It didn’t hurt, but from every picture I saw it was very clear. I splinted it that night myself and have been very careful. There was a little swelling that has gone down since that time. I did not go to a doctor since it seemed very clear what I had and very clear what the treatment is. I did have a nurse look at it (out of the office) and she said that she couldn’t feel any major break. My question is what should I do at 6 weeks? Am I just making sure I can hold the tip of the finger up after I take off the splint?

    • drdavidgeier says:

      If a patient has a mallet finger, then the hand surgeon would assess the finger to determine if he or she regained full motion and extension strength. I’m glad this discussion and my blog have helped!

      • Mark says:

        Thank you for the response. If I may, I have one more question. I’ve been going to the gym with my finger splinted. I usually do a half hour of cardio and a half hour of weights. I’ve been concerned that the weight lifting has not been good for my finger. My finger has always been in the splint during any exercise. But sometimes, while lifting, I can feel the tension up through my finger. If I keep my finger straight in the splint, do you think I can do harm because of the tension on the healing tendon?

        Thanks again

  29. TOM says:

    Hello dr, I broke my ring finger in moto accident, after 4 weeks of splinting (not straight splint) it was curved, I was surprised that when I close my fingers it malrotated on the small finger, the doctor say that it is not good to make surgery and I should keep it like that but I m suffering from this situation especially in my work because I used it to wright, do u have any comments on my situation, many doctors say that if I make the surgery I can’t close my finger like now

    • drdavidgeier says:

      I am not a hand specialist, but patients with finger fractures that heal in a malrotated position often have difficulties with the function of the hand. I recommend to patients with finger fractures unsure if they need surgery that they seek out the opinions of a hand surgeon.

  30. Brett Greenough says:

    Hello Dr Geier,
    I recently jammed my finger in a basketball game. I played two more games and noticed my finger still didn’t look healed. I went to the doctor and got a x-ray. They said that there was a fracture and that i had mallet finger and they put me in a splint. He said that I couldn’t play basketball for around 6 weeks. Could you please tell me if there is any way I can play? I can’t stand being on the sidelines. I missed the first game tonight and it was horrible. I don’t want to not play for six weeks. Please let me know if there is any possible way I can play. And If I do play, will it make it worse? Or will it just not heal and I can wear the splint after basketball season is over? Thank you for your time sir.

    • drdavidgeier says:

      Thanks for the question, Brett. I have answered almost this exact question about playing basketball with a mallet finger. Check out the podcast episodes where I answer questions about mallet finger injuries as well as the other questions asked by readers in this post.

  31. Justin Allen says:

    Hello Dr. Geier,

    I just completed 8 weeks of treatment with a stack splint. It has been off for three days, and I’m happy to say that my (index) finger can stand straight on its own. However, I still have two questions for you:

    1. How long does it typically take to get over the stiffness regain motion? This one I’m not worried about at the moment…just curious.

    2. I have a bump on a dorsal side of the joint, and with the research I’ve done online, I’m beginning to fear it’s a part of the bone. Is this normal, or something I should discuss with a hand surgeon? (My primary care physician did not do an X-ray.

    Thanks so much for all your help here!

    • drdavidgeier says:

      Stiffness after splinting for a mallet finger can persist for weeks, as that joint hasn’t moved in a while. Working with a hand therapist to regain range of motion can often be helpful. X-rays are useful early in the evaluation of possible mallet finger injuries to determine if they are purely tendon injuries or small bony fractures.

  32. Vincent says:

    Hello Dr. Geier,

    I injured my small finger 3 days ago playing basketball. I made a DIY splint using popsicle stick and tape. I would like to know how tight should i tape my finger? Is it okay to remove my splint after taking a bath to replace the wet tape? Is it okay to leave the tip hanging while I dry my finger and the popsicle? Thanks.

    • drdavidgeier says:

      In general, mallet finger injuries must be kept in full extension or even slight hyperextension until they heal. Patients need to keep that joint extended even when showering in order to prevent disruption of the repair. Vincent, honestly I would suggest you see a hand surgeon to ensure the correct diagnosis and appropriate treatment in your particular case.

  33. Kim says:

    Hello Dr Geier,
    I got a mallet middle finger through a taekwondo match 8 weeks ago.The Doctor said that a small part of the bone is broken with it and inserting a pin is a better option for me.He removed the pin after 6 weeks and said that i should wear a night splint for 6 weeks.It is now 2 weeks that the pin is removed…After removing the pin my finger started to swell up in the next day (arthritis) between the joint and the nail, and now after two weeks it still looks a bit bigger than normal (but better than the first day after the pin removal)

    1- Is this swelling normal and how long does it take to settle down ?
    2- My finger is stiff.I have tried to bend the joint carefully but It feels a bit painful and rigid.Do i have to visit a physiotherapist? my doctor said that there is no need for physiotherapy through these weeks! but i’m worried that the stiffness gets worse.
    3- How long does it take for this nightmare to completely end!? :(
    Thanks

    • drdavidgeier says:

      Again, as I have said many times in these comments, I can’t give you specific advice. I would ask your surgeon or another one these questions. Generally I often recommend physical therapy or occupational therapy to patients in order to regain motion after healing of a joint injury to try to regain range of motion of that joint. Hope that helps!

  34. Michael says:

    Hello Dr. Geier -

    I have what I think is a general question. I have suffered a mallet finger fracture in my pinky (about 1 mm fracture). It never really hurt and I can almost straighten it out fully.

    I am wondering if the range of motion in the finger could get worse if the finger is not splinted or if it is “as bad as it will get” at the time of the injury. How would the fracture heal differently if not kept in the splint?

    I am asking because I could live with the slightly crooked joint at the end of my pinky if it means avoiding six weeks in the splint. But if there is a risk of it getting worse as it heals, then I would probably go with the splint.

    I know that you cannot give specific advice, but if you could share any knowledge you might have about how mallet finger injuries heal when not splinted would be great. Thanks so much!

    • drdavidgeier says:

      Great question, and I would say (as I do will all of these questions) that I can’t say specifically with you. Generally I think the splint doesn’t bother patients as much as we would think, but it is inconvenient. Most would rather have full function and range of motion and deal with 6-8 weeks in a splint. Whether it would get worse would be hard to say, but it would certainly be possible.

  35. christopher says:

    Hi Doctor,
    I had a bony mallet pinkie finger 8 weeks ago. I’ve splinted it for 6 weeks but it doesn’t look any better. I’m going to my surgeon this week to see what could be done. In your opinion could this be corrected without open surgery. I’ve read about the block technique and I don’t know if my injury is to old to apply this.

    • drdavidgeier says:

      That is one I would advise you to ask your surgeon. What options are available depends on specific findings on your physical exam and radiographic studies.

    • Anthony says:

      Dear doc I was playing football about 3 or 4 months ago and hit my finger I thought it was just a jam and would heal on it’s own but never did then later on found out I have mallet finger it’s been 4 months and I have had no medical treatment do you think I can get surgery and have it back to normal after so long ?

      • drdavidgeier says:

        Surgery can be an option for many patients with chronic mallet finger injuries, but the surgeon involved in your care would have to answer that specifically in your case.

  36. Christopher says:

    Thanks Dr.Geier for the quick response. I’m so lucky I found out that I’ll have surgery on my finger and hernia repair at the same time. This will definitely keep me quiet for 6 weeks. I’ll keep you posted in a few weeks to inform you and your readers how it went. Keep up the good work.

  37. Katie says:

    Hi Dr. Geier,

    I have had a mallet finger for 8 years. The year I incurred the injury, I didn’t see a doctor for several months. When I finally visited an orthopedic doctor, he took a look at my x-rays and said “Your finger will not be straight again. If you have no pain, and there is 95% functionality in your finger, we should leave it as is”.

    My finger is not only dropped, but bent at an 80 degree angle, and there’s a bump which feels like a fractured bone. I’m resigned to the fact that my finger may never be straight, but I would like to at least fix whatever outstanding bone injury I may still have.

    My question is, will an orthopedic surgeon consider my case and is there even a realistic medical treatment at this point?

  38. christopher says:

    I finally had the surgery. Elevated pain even with meds between 48-60 hours. After 72 hours pain was better tolerated. I’m anxious to see how will my finger feel in the next 3 to 6 months. I had this procedure done from a hand surgeon.

    I had a bony mallet fracture which is well described in this youtube video.
    http://youtu.be/s2CjDh8agR4

  39. Nicole says:

    Hi,
    I have a mallet finger and the doctor told me to remove it once a day to clean the skin. When i was cleaning it, my hand supporting my finger slipped but I supported my finger again instantly. I think it stayed straight but I’m not positive. Will I have to restart the 6 week healing process all over again? I am 3 weeks into recovery.

    • drdavidgeier says:

      I can’t really say without seeing it. Generally keeping it straight is needed to avoid stress on the healing tissue.

  40. Yvonne says:

    I experienced a mallet finger about five years ago. It was splinted. The pain went away but I’ve always had stiffness in the joint. A couple of days ago the top of the finger has become quite painful and tingles at times. What could be going on?

  41. Daniel says:

    Hello,

    I have done 6 weeks of splinting and my finger can hyper extend again! This is wonderful, however, keeping it hyper extended when the splint is off is about all I can do. I know I need to take it easy in the first week as I gradually remove the splint… but I was wondering if there are any exercises I can do to begin increasing my ROM safely?

    Thanks

    • drdavidgeier says:

      I would ask your surgeon if it is safe to start bending your finger and if he or she thinks working with an occupational hand therapist would be beneficial to regain finger range of motion.

  42. Raymond says:

    GI have a ruptured tendon and I kept the splint on for a full week then switched it with one that I saw at the store cause the one the doctor gave me was uncomfortable because they put it on wrong they put it on top but now its been 3 weeks and I took it off to see if its ready but felt tingly and hurt when I tried to grab something. I wanna know if it can still heal without sugery? And if it was supposed to hurt .

    • drdavidgeier says:

      Raymond, I really cannot give you a specific answer to your question, as I am not involved in your care. I would ask your orthopaedic surgeon. Read the comments above, as I think many have had similar questions.

  43. Yousef says:

    Hello ,
    I had a mallet finger and treated it in a splint for two month without removing the splint once , just to get the best result. when the splint was removed the finger looked straight , swollen , and stiffed. After 1 month which is the meantime it bent or dropped again after having the physiotherapy , though the swelling and stiffness slighty decreased and the function is getting better. My question why is it bent again and how can i fix it. Thanks

    • drdavidgeier says:

      Sorry Yousef. You’ll need to ask your surgeon. He or she can examine your finger and give you an answer.

  44. Daniel says:

    Hello,

    I am fairly recovered from my mallet fracture. I can flex my finger 90% of the way, but I cannot make a full fist. Can I use my other hand to help flex the finger further or will it come naturally? My OT is on vacation and I begin my baseball season next week… I am cleared to play, I just dont know if putting direct pressure to initiate flexion is wise. Getting this last little bit is super frustrating.

    Thanks again

  45. Daniel says:

    Also, to add to the above comment, can you possibly recommend any activities or exercises I can do to get that last bit? I will do anything I possibly can, getting this hand back to normal ASAP is my top priority and means a lot to me.

  46. christopher says:

    I just took out the pin from my finger. It seems stiff and range of motion is difficult. Don’t forget the finger was immobolized for 8 weeks after surgery and many weeks before that. The good news is that 24 hours after pin removal I see a little movement :). I have to do some exercises for a month and see how it goes before really forcing. I have to splint it at night for another month.
    I’ve had many injuries in the past but this one is the most annoying of them all. So patience is a vitue to get better.

  47. Gokul says:

    Hai doc,

    i have a mallet finger. And i am under treatment. After few weeks i removed my splint without doctors permission and went to play. while playing the ball struck on the same mallet finger and its paining very hard i cant move that finger. What to do about it? Please reply. Immidiately.

    • drdavidgeier says:

      All I can tell you, above what is written in this post and all of these comments, is to go see your doctor.

  48. J.Mathews says:

    Hi,
    I am having a mallet finger and started wearing the splint 36 days back. While taking bath the splint easily comes out and my fingertip is bent little upwards as it seats in side the splint. There is no pain and swelling. How do i know if my finger is healed or not. When can i remove my splint. Thanks..J. Mathews

  49. r. parker says:

    ok so I had a mallet finger and I went to the doctor and I ended up chipping off the bottom part of my bone on the top part of my finger. I was required to have surgery. I had surgery on april 30. they put three pins in my finger. I went back to the doctor for a check up, they took out my stitches but said my pins have to stay in two more weeks! though I play soccer and the state tournament is coming up (memorial day weekend)and I want to play soooo bad! is there any possible way they could take my pins out early or couldn’t they cast my finger so I could play? is there any way in the world that I can play?? I open to all suggestions!! thank you for your time!

    • drdavidgeier says:

      Sometimes there are ways to play sports while pins are in place or a fracture is still healing, but it depends on the sport and activities with the hands, how stable the fixation is, and how the healing is progressing. Unfortunately I can’t give you advice on what you could or should do, but I would ask your surgeon those questions. He or she might figure out a way to get you to play.

  50. Gokhan says:

    Hi Dr. Geier,

    I had a surgery last Friday. The doctor inserted pins in my finger. My question is whether I can swim with these pins in pool? Of course, after sutures and wounds are removed.

  51. Christopher says:

    Hi Gokhan I’m no doctor but there’s a pin in your finger so an opening exists for bacteria
    entry. I would wait until the pin is removed.
    I got the surgery 3 months ago. I followed a finger block exercise routine and improved my
    range of motion while splinting at night. My finger is still stiff but it did improve 50percent.
    I also received Prolotherapy injections recently
    to improve healing, I do not promote this treatment but it helped me in the past with other
    ligament injuries so I hope it does the same
    for my mallet finger recovery.

    • Gokhan says:

      thank you very much Christopher. I have seen your response now. It has been 1 month since the pins were removed. As you suggested, I did not try swimming during that period.
      I have another question. My finger has been swollen since the pins were removed (and of course lack of movement ). Is the swelling still normal? Have you lived such an experience?

  52. Walter says:

    After 10 weeks splinted with a mallet finger injury to my ring finger (4th finger) I had the splint removed. My third, fourth and fifth finger are swollen and too stiff to make a fist. Is such swelling common? There is swelling around my knuckles as well. After one week I have been able to close my hand somewhat; but, feel a snapping at the palmer side of the PIP joint to my middle finger when I open my hand. I was wondering if this was common as well. I feel no pain other than my skin feeling tender on the dorsal side of the finger I had injured.

    • drdavidgeier says:

      Stiffness and swelling are not uncommon after mallet finger injuries. Your hand surgeon can tell you more specifically if it is expected in your case.

  53. Charles says:

    Hi Doctor Geier,

    I’ve recently been diagnosed with mallet finger. I’ve been put in a split for 6weeks as treatment. As I am a goalkeeper when playing football (this is how I got mallet finger in the first place) when would it be safe to go back and play in goals? Straight after the 6 weeks?

    Thank you.

  54. Dr. Linda Caputo says:

    I injured my pinkie June 23 sustaining a mallet injury and have been splinted since June 25. I taped it myself when the injury occurred as it happened on a weekend, saw an orthopedist ASAP. I wanted to see ahand specialist but he was on vacation and several other docs weren’t seeing patient’s until August. What are the chances of the splinting not working and will I be able to treturn to playing tennis.
    Dr. Caputo

    • drdavidgeier says:

      I can’t say in your case specifically. Typically splinting works well assuming the patient does it religiously. The goal with treatment would be to allow the patient to return to all activities and exercise.

  55. Yosi says:

    Hi Dr. Geier,

    I was hit by a cyclist and feel down. My 3rd finger broke the fall went, back and had an avulsion fracture. The ER said to just buddy it, then then recalled me and said they should put a loose splint made of some plaster material at the bottom and a tensor bandage around the top to hold it on. My hand stayed in that for 3 weeks. The finger wasn’t extened like in a normal splint. Now my finger doesn’t sit straight and is very swollen. The orth surgeon spent no time with me and said it may be like that permanently..is that true?? Or after the swelling goes down (around the knuckle) will the finger straighten out? I’m upset that they didn’t put it in a straight split in the ER… would that have helped?

    • drdavidgeier says:

      I wish I could give you advice, but I cannot without being involved. I would ask your surgeon or another one you feel comfortable seeing.

  56. Melissa says:

    Hi Dr.,
    My daughter injured her right ring finger playing volleyball. I took her to her doc next morning and he sent us to ER. After waiting 4 hours they diagnosed her with avulsion fracture or mallet finger and they put s plint on her finger and referred us to a hand specialist. This was on a firday before labor day and os I am not expecting to hear from hand specialist til Tuesday. After researching this injury on the internet, everything I have read has stated that the splint should keep her finger in a straight position to help heal the tendon but the ER splinted her finger and it still looks bent at the tip. Also we were never informed of the importance of keeping the splint on her finger and she took it off last night and slept without her splint! Now I am very concerned that we messed up her healing process! What should I do? Should I try to splint her finger so it is straight or should I take her back to the emergency room? I am really just freaking out here! Please help.

    • drdavidgeier says:

      I can’t say specifically in her case without being involved in her care. Generally a patient who removes the splint and the finger flexes again can simply put the splint back on and start the process over. Her surgeon can give her better advice for her injury, but removing a mallet finger splint often only prolongs the time a patient will need to wear it.

  57. Sara says:

    Hi well i hurt my finger 3 days ago and i can’t move it…. i hurt out playing ballsketball it hurts really bad plz answer this

  58. John says:

    (mallet finger, yesterday)

    Hi,
    my doctor said to me i can do any sport activity until my splint remains in perfect place for all the time…

    what i can’t understand is:

    if i unvolontary contract muscles connected with the healing tendon, is not possible that the pulled tendon can break again even if the finger can’t move (bend) at all?

    Thanks

    • drdavidgeier says:

      I can’t say specifically in your case without examining you. generally keeping the joint immobilized without the ability to bend will allow the tendon to heal.

  59. ALMERO says:

    HI MY DAUGHTER 13 GOT MALLET FINGER OR SO THEY THINK THEY CANT DIAGNOSE IT BECAUSE SHE DID NOT INJURED HER FINGER WHAT CAN IT BE?

  60. Karan says:

    Hi Dr. Geier,

    I am a medical student and I was treated for a mallet thumb 6 weeks ago with a splint that kept my thumb in constant extension. After 6 weeks, my thumb is no longer flexed and now naturally rests in an extended state, which I assume means the tendon has healed. However, now my thumb won’t flex and there is considerable stiffness over the distal joint. In addition, the distal joint is much larger with a bump over it. Is this stiffness/inability to flex normal in the healing process? Is there anyway I can regain full flexor/extensor ability for my thumb? As it is my right/dominant thumb, I am very concerned about occupational problems and the long term effects, especially since I am considering specializing in surgery.
    Any input would be appreciated. Thank you!

    • drdavidgeier says:

      I can’t say specifically in your case, but stiffness in the days and weeks after finishing the splint treatment for a mallet finger is common since the finger remained in one position for weeks. Often an occupational therapist can work with a patient to help regain hand range of motion and complete function.

  61. Ann says:

    Hello dr Geier,
    I have a mallet finger for 5 years. I was a litttle girl then and my big mistake was not keeping a splint.but nowadays i dont feel comfortable with my finger.is there any chances to treat it through surgery and to make any progresses.the finger is not bend but it has a big wound in front of and it looks strange.looking forward for your answer

    • drdavidgeier says:

      I can’t say without examining your finger. I would see a hand surgeon and inquire about possible treatment options.

  62. George says:

    Hello Dr Geier!
    Same story, different treatment option given from DR at a walk in clinic here in Clearwater.
    Middle finger Mallet happened today. ZERO PAIN, ZERO SWELLING, just the tell tale droop.
    Dr gave me an xray, he says ZERO fractures. Recommends 7-10 days of splint and thats it.
    EVERY other thread/story says same 4-6 weeks.
    Have u ever heard of 1-2 weeks healing time?
    Is that medically possible?

    • drdavidgeier says:

      I haven’t heard of the timeframe you mention, but I can’t say specifically in your case without being involved.

  63. Mohib says:

    Hello Dr. Geier,
    I have a mallet finger since two days, my finger is now on a splint, the doctor advised to see me after a week, am afraid that he removes the splint during the check up. Is it better that I follow up with him 6 weeks from fixing the splint to avoid any risks, or shall I follow up after a week as per his recommendation?

    • drdavidgeier says:

      Patients should do whatever a physician or surgeon advises and discuss any concerns at that point. It is possible for a surgeon to be checking to see if a splint is fitting correctly and doesn’t intend to remove it just yet. I can’t know without being involved in your case, though.

Leave a reply

ABOUT ME
david-headshot I am an orthopaedic surgeon and sports medicine specialist in Charleston, South Carolina.

On this blog, on my podcast, and in articles for numerous publications and in media interviews, I aim to provide you leading commentary and education on injury treatment and prevention to keep you performing at your best! Learn more about me >>


MEDIA

I'm excited to help with information and interviews for print, radio, television, and online media. Media information >>

WRITING

Writing I write articles and columns for a number of publications and organizations. Writing information >>
Sports Medicine Simplified: A Glossary of Sports Injuries, Treatments, Prevention and Much More

glossary-cover
Learn more about the glossary >>
© 2014 Dr. David Geier Enterprises, LLC

Site Designed by Launch Yourself