Mallet Finger
Mallet finger care with Dr. Steven Ward in Tucson and Oro Valley — treating a fingertip that droops after the tendon that straightens it is injured, most often with a splint and occasionally with pinning.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb. It usually happens when something, like a ball, strikes the fingertip and forces it to bend. Sometimes it happens with something as small as tucking in a bed sheet.
- The fingertip droops and will only straighten if you push it up
- Pain, swelling, and bruising over the end joint
- The tendon may tear, or pull off a small piece of bone (an avulsion fracture)
Seek care right away if there is blood under the nail or the nail is pulled loose. That can mean a nail bed cut or an open fracture, which carries a risk of infection. Untreated, mallet finger can leave a stiff, bent fingertip or a “swan neck” deformity.
Is surgery right for you?
Most mallet fingers heal without surgery, with a splint that holds the fingertip straight:
- The splint is worn full time for 6–8 weeks, including while bathing
- If you take it off to clean the finger and skin, hold the fingertip straight on a flat surface the entire time. If the tip droops even once, healing is disrupted and splinting may need to start over
- Check your skin under the splint for irritation
- Afterward, the splint is worn less over 3–4 weeks, often only at night
Surgery may be recommended if a large piece of bone is pulled off, the joint has slipped out of line, or you cannot wear a splint full time. Many people do not get perfectly full straightening back, even with good treatment.
How the surgery is done
Surgery for mallet finger is an outpatient procedure done with numbing medicine.
- Pinning — a temporary pin across the end joint holds it straight, acting as an internal splint, usually for about 8 weeks
- Fracture fixation — when a large bone fragment is pulled off or the joint is out of line, the piece and the joint are realigned and held with pins
- Fusion — for an old mallet finger that is painful or limits use, the end joint may be fused in a straight, useful position
When there is no fracture and the joint is lined up, surgery on the tendon itself is uncommon, because the tendon is very thin and hard to stitch. Splinting is usually the better choice.
First aid while you wait
Ice the finger and keep your hand raised above your heart. A padded splint that holds only the fingertip straight can protect it until you are seen; make sure it does not block the other joints from bending.
Try to be seen by a hand surgeon within about a week. Some fingers still heal well when treatment starts later, so it is still worth being seen.
Recovery overview
Typical ranges only, based on AAOS OrthoInfo patient education. Dr. Ward’s plan for you may differ.
Weeks 0–8
- Splint on full time for 6–8 weeks, with the fingertip held straight
- Keep moving the other joints of the finger and the rest of the hand
- Follow-up visits to check the splint, your skin, and healing
Weeks 8–12
- Gradually wear the splint less over 3–4 weeks, often at night only
- Start gentle bending of the fingertip as instructed
- If the tip starts to droop again, tell the clinic
If you had pinning
- The pin usually stays about 8 weeks and is removed in the office
- Keep the pin site clean and dry as instructed
- Surgery carries a higher risk of complications than splinting, including infection around the pin
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- Fingers that turn pale, blue, or cold
- Numbness or tingling in the hand or fingers that does not go away once the nerve block or numbing medicine has worn off, or that is getting worse
- A cast, splint, or dressing that feels too tight: throbbing pain, swelling, or numbness under it that does not ease after you raise your hand above your heart and gently move your fingers. Do not cut or remove a cast yourself
- Pain that is not controlled by your prescribed medication, elevation, and ice
- The fingertip droops again, or your splint slipped and the tip bent while it was off
It is normal for the hand and fingers to be swollen, bruised, and sore for a while, and for the hand or arm to stay numb and weak for several hours after a nerve block or numbing medicine. Keep your hand raised above your heart, and move the fingers that are not splinted as you were shown. Call if something feels different from what you were told to expect.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Exercise guides
Hand & wrist handouts, including carpal tunnel exercises and hand and finger exercises.
Open pagePatient resources
Surgery packets, pre-op and post-op instructions, exercise guides, and videos in one place.
Open pagePost-op packets
Dr. Ward’s post-operative instructions and packets, organized by joint.
Open pageWrist fracture (distal radius)
Dr. Ward’s broken-wrist page: splint care, swelling control, and the week-by-week rehab plan.
Open pageOrthoInfo: Mallet finger
Patient education on mallet finger from the AAOS.
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