Mallet Finger Treatment in Durango, Colorado

Mallet finger is an injury to the tendon that straightens your fingertip, causing it to droop down. Most cases heal well with full-time splinting for 6 to 10 weeks — surgery is only needed when a large fracture fragment shifts the joint out of alignment. With proper treatment, most patients return to full activity with a finger that works well for everyday life.

What is a Mallet Finger?

A mallet finger happens when the extensor tendon (that straightens your fingertip) gets injured (torn or fractured where it attached). The tendon attaches to the last bone in your finger. When it tears or pulls away, your fingertip droops down. You can't straighten it on your own.

Sometimes the tendon tears by itself. Other times, it pulls off a small piece of bone with it. We call that a "bony mallet." Either way, the result is the same — a fingertip that won't straighten.

How Does This Happen?

Most of the time, something hits the tip of your finger while it's straight. The force jams it down and the tendon can't handle the load.

Common causes:

Catching a ball (basketball, baseball, football)
Tucking in bed sheets
Pulling on socks or pants
Any forceful impact to the fingertip

It doesn't take much. I see patients in Durango all the time who are surprised that something so simple caused this injury.

What Does It Look Like?

The signs are pretty obvious:

Your fingertip droops and you can't straighten it
Swelling at the last joint of your finger
Pain on top of the fingertip
Sometimes bruising

If your fingertip is drooping and you can't straighten it, you likely have a mallet finger.

How is Mallet Finger Diagnosed?

I'll examine your finger and check your ability to extend the tip. An X-ray tells me if there's a fracture involved. That matters because a large bone fragment can change the treatment plan.

Treatment

Here's the good news: most mallet fingers don't need surgery.

Splinting is the standard treatment. A splint holds your fingertip straight (or slightly extended) for about 6 to 10 weeks. I usually recommend nighttime splinting (and splinting with risky activities) after that for another month. This gives the tendon time to heal back to the bone.

The catch? You have to keep the splint on all the time. Day and night. Even in the shower. If the fingertip drops down — even once — the healing process can reset. That means starting the clock over.

I know 6 to 10 weeks sounds like a long time. But the splint only goes on the last joint of your finger. The rest of your hand works normally. Most patients adapt quickly.

A few rules for splinting:

Keep the fingertip straight when you clean or change the splint
Don't let it bend, even for a second
Keep the skin under the splint clean and dry
Call me if the skin gets red or breaks down

As far as splints go, after many years of treating people for mallet finger, I have developed an all-in-one mallet finger splinting kit which includes everything that is needed to treat mallet finger from start to finish. It has splints that are sturdy enough to allow sports, and includes a trustworthy changing technique, to minimize the risk of accidental bending. It's called "Mallet Pro" and it's available at www.malletpro.com.

After splinting, I'll have you wean out of the splint gradually. You may wear it at night for a few more weeks. Gentle motion exercises start once the tendon has healed enough.

Treatment

Surgery is uncommon, but I recommend it in certain situations:
A large fracture fragment (roughly a third or more of the joint surface) that causes the joint to shift out of alignment
The joint is subluxed (partially dislocated)
Splinting has failed after a full course of treatment
An open wound at the injury site
Surgery usually involves pins to hold the bone and joint in proper position while everything heals. I perform mallet finger surgery at Animas Surgical Hospital in Durango when it's needed.

What Results Can You Expect?

Most patients get a good result with splinting alone. Your finger will work well for everyday activities.
That said, here's what I tell patients to expect realistically:
A small amount of droop (a few degrees) at the fingertip is common, even with perfect treatment. Most people don't notice it in daily life.
Full extension can take several months to reach its final point.
Stiffness at the fingertip is normal early on and improves with time and gentle use.
Most patients return to full activity without restrictions.
If treatment is delayed — say you waited several weeks or months — splinting can still work. The results are just less predictable.
Left untreated, a mallet finger can lead to a "swan neck" deformity over time. This is where the middle joint of the finger starts to hyperextend. That's harder to fix, so it's better to get treatment early.

When Should You See a Hand Surgeon?

If your fingertip is drooping and won't straighten, get it looked at. The sooner treatment starts, the better the outcome.
I see patients with mallet finger injuries at my clinic in Durango, and I also serve patients from Cortez, Pagosa Springs, Farmington, and across the Four Corners region. You can reach me at 970-403-5333 or email me at doctorbutzen@gmail.com.
For a quality splint option for mallet finger, try a Mallet Pro