Introduction 

Mallet finger is an injury to the end of the finger that causes it to bend in the direction of the palm.

You won't be able to straighten the end of the finger because the tendon connecting the muscle to the finger bone is stretched or torn. The finger will also be painful and swollen. Sometimes a small fragment of bone breaks off with the tendon.

Mallet finger is most often caused by a minor injury, such as catching the finger on clothing or bedding.

It's also a common sports injury, particularly in sports where a ball or other object can strike the end of a finger.

In some cases, mallet finger can be caused by a cut to the end of the finger on the side of the nail.

What should I do?

If you think you have mallet finger, go to your nearest minor injuries unit or accident and emergency (A&E) department to have it splinted. You should do this as soon as possible – the earlier it's treated, the better the outcome.

Try to keep your hand raised until the doctor sees you. This helps to reduce any swelling and pain. Take off any rings on the affected finger, as swelling may make it difficult to remove them later or may cut off the blood supply to the finger.

You can take an over-the-counter painkiller, such as paracetamol or ibuprofen, to relieve the pain. Once your finger is splinted, applying an ice pack a few times a day for 10 to 20 minutes may also help reduce pain and swelling.

How is it treated?

Your finger will be placed in a plastic splint, which keeps it straight with the end joint slightly bent backwards. You'll still be able to bend the finger at the middle joint. Sometimes a custom splint is made by an occupational therapy team if a standard one doesn't fit well.

The splint is taped on and must be worn day and night for 6 to 12 weeks to allow the two ends of the torn tendon to stay together and heal. It should only be removed for cleaning.

It's really important that the end of your finger doesn't bend during the time it's splinted, as this may slow down healing and reduce the effectiveness of the treatment. The middle joint of the finger is left free so you can continue to move it to prevent any stiffness developing.

You should only need surgery if the finger bone has broken (known as a mallet fracture or bony mallet injury), or in the uncommon situation where the mallet finger fails to heal.

How do I keep my finger and splint clean?

The splinted finger must be kept clean and dry at all times. If the skin becomes wet inside the splint, it will become very sore.

It's important to wash both your finger and the splint at least once a day, following these instructions:

  • Keep your finger flat on the table, cut the strapping, and slide the splint off your finger.
  • Wash and dry your finger and the splint using soap and water. Keep the end joint straight at all times by keeping your finger flat on the table. You may find it easier if someone helps you do this each day, as any movement of the end of the finger will delay the healing of the tendon and may even cause permanent damage.
  • Slide the splint back over the fingertip, still keeping the finger straight.
  • Replace the strapping – this should cover the middle of the splint, but should not cover the middle joint of the finger.

How long will it take to heal?

Your mallet finger should heal within 6 to 12 weeks, after which time you'll be able to use the finger again. You may be advised to continue to only wear the splint at night for up to four more weeks.

Sometimes you only need to see a specialist once, as a hand physiotherapist can take over your care. They'll provide you with exercises to perform at home to help prevent stiffness in the finger.

Depending on your job, you may require time off work. It's important to avoid any sports involving the hands while your injury is healing.

It may take several months to regain full function. Redness, swelling and tenderness of the skin around the end of the finger are common for three or four months after injury, but usually settle eventually.

Fractures involving the joint of the finger also increase the risk of arthritis in the future. You may be left with a small bump on the top of the joint and a slight loss of ability to straighten the joint – it never really goes completely back to normal. However, the finger should generally function well.

Page last reviewed: 18/03/2015

Next review due: 18/03/2017