Mallet finger

Background

• Rupture of extensor tendon in area of distal phalanx distal to DIP joint
  • May be accompanied by avulsion fracture
• Caused by forced flexion of the DIP joint

Clinical Features

• Results in DIP joint flexed 40'

Differential Diagnosis

Hand and finger injuries

• Distal finger
  • Finger amputation
  • Fingertip laceration
  • Nail avulsion
  • Nailbed laceration
  • Subungual hematoma
• Other finger/thumb
  • Boutonniere deformity
  • Mallet finger
    • Swan neck deformity
  • Jammed finger
  • Jersey finger
  • Trigger finger
  • Ring avulsion injury
  • De Quervain tenosynovitis
  • Infiltrative tenosynovitis
  • Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb)
• Hand
  • Dupuytren contracture
• Wrist
  • Drummer's wrist
  • Ganglion cyst
  • Lunotriquetral ligament instability
  • Scaphoid fracture
  • Extensor digitorum tenosynovitis
  • Compressive neuropathy ("bracelet syndrome")
  • Intersection syndrome
  • Snapping Extensor Carpi Ulnaris
  • Vaughn Jackson syndrome
• General
  • Hand and finger dislocations
  • Hand and finger fractures
  • Hand and finger infections
  • Gout and pseudogout
  • Hand and finger tendon injuries
  • High-pressure injection injury
  • Osteoarthritis
  • Rheumatoid arthritis
  • Ring removal

Treatment

1. Splint DIP joint in continuous slight hyperextension x 6wk
2. must be without interruption for entire time
3. given extra splint for shower
4. ortho in 7-10days

See Also

• Radiograph-Negative Hand and Finger Injuries

Source

• Tintinalli
• Atlas of Emergency Medicine