Splinting Options for Treating a Mallet Finger

Causes of Mallet Finger 

Your patient caught the tip of his finger in a drawer and now his fingertip is drooping because the extensor tendon has stretched, pulled away, or torn. The finger can be pushed into extension, but cannot stay straight without support. Mallet Finger, also called Baseball Finger, affects a small area but can become a big problem if left untreated.     

Symptoms of Mallet Finger

• Loss of active extension of the distal interphalangeal (DIP) joint
• Swollen fingertip
• Possible bruising or open wound over the dorsum of the DIPJ
• Fingertip can be pushed into extension but will not stay straight without support

Treatment for Mallet Finger

Mallet Fingers should be treated as quickly as possible with a splint that immobilizes the DIP joint for 4 to 6 weeks. Delayed treatment may still be effective with good adherence to a long term splinting program. Untreated Mallet Finger my ultimately result in the development of PIP joint hyperextension or Swan Neck deformity.

Finger Splinting Options for Mallet Finger

1. Aluminum and Foam Strips:

 Advantages:

• Light weight and readily available

Disadvantages:

• Must be taped in place
• Patient cannot readily wash their hands while wearing
• The foam will degrade over time
• Skin can get macerated from lack of air getting to the skin
• Splint limits finger use

(Alex Orthopedic Aluminum Splint)

2. Stax Splint:

 Advantages:

• Lightweight and holds the fingertip straight

 Disadvantages:

• Must be taped on
• Covers the fingertip so patient’s finger cannot be used
• Difficult to wash hands while wearing
• Skin gets macerated
• Can be difficult to fit

(Stax Finger Splint)

3. Oval-8® Finger Splint

 Advantages:

• One or two Oval-8 Finger Splints may be used to hold the DIP joint in extension while still allowing flexion of the proximal interphalangeal (PIP) joint
• Lightweight-- the fingertip is open for function
• Open design eliminates skin maceration
• Size adjustability designed into the Oval-8 accommodates changes in swelling
• Patient can wash hands easily by removing the splint
• Easy to slide on and off for skin care
• Gel sheeting can be recommended for cushioning and to protect the skin and cushion crush injuries
• With 14 heat adjustable splint sizes, it is easy to achieve a custom fit.
• Available in CLASSIC Beige and NEW Oval-8 CLEAR

 Disadvantages:

• Professional adjustments may be needed for a custom fit
• May fall off if weather is cold or swelling decreases

          Oval-8 Finger Splint

After Splinting Treatment For Mallet Finger

It is important to follow patients after splinting. If symptoms do not improve in 4 to 6 weeks, patients should be referred for additional treatment or surgical intervention.

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