Mallet finger

Also called Dropped fingertip, Baseball finger

A fingertip that will not straighten after a knock. Eight weeks in a splint, never removed, or it does not heal.

What it is

An injury to the tendon that straightens the fingertip, usually from a direct blow to the end of a straight finger, which forces it to bend suddenly.

It is common, often from sport, catching a ball, tucking in a bedsheet, or a knock in ordinary life. The tendon either tears or pulls off a small fragment of bone.

The result is a fingertip that droops and cannot be straightened actively, although it can be pushed straight passively.

**The treatment is a splint holding the fingertip straight, continuously, for six to eight weeks.** The crucial word is continuously. If the fingertip is allowed to bend even once during that time, including while washing or changing the splint, the healing tendon separates and the clock starts again. That single instruction is what determines whether it heals, and it is frequently not explained clearly enough.

Changing the splint therefore requires keeping the finger flat on a table, using the other hand, and never letting the tip drop.

Untreated, it heals with a permanent droop, which is a cosmetic and functional nuisance rather than a disaster, and can later cause a swan-neck deformity.

Surgery is needed only for large bone fragments, joint subluxation or open injuries.

Signs you might notice

A fingertip that droops and cannot be straightened actively after a knock.

Pain, swelling and bruising over the top of the last joint.

Ability to straighten it passively with the other hand.

Sometimes a small painful bump over the joint.

See a doctor or minor injuries unit promptly for assessment and an X-ray, which shows whether a bone fragment is involved.

Urgent: an open wound over the joint, which risks joint infection; or a fingertip that is pale, cold or numb.

Do not simply strap it to the next finger; it needs a specific splint holding the tip straight.

How it can affect day-to-day life

Eight weeks in a splint is genuinely inconvenient: washing, typing, dressing and work all have to accommodate it, and people give up early, which is why so many end with a permanent droop.

The splint must be kept dry, and washing routines have to change. A second splint allows one to dry while the other is worn, which is a practical trick worth knowing.

Skin problems under the splint are common: maceration, pressure areas and soreness. Checking the skin during a careful splint change, with the finger flat, prevents them.

Even with perfect treatment, a small residual droop of a few degrees is common and does not usually matter functionally.

An extra period of night-time splinting after the main course is often advised, and helps consolidate.

Hand therapists are the people who fit these best and who teach the change technique properly; asking for that referral is worthwhile.

Supporting someone well

Get it assessed and X-rayed early.

Wear the splint continuously for the full six to eight weeks. Do not remove it to rest, wash or sleep.

Learn to change the splint with the finger flat on a table, using the other hand, never letting the tip bend.

Keep a second splint so one can dry.

Check the skin at each change, and report soreness or breakdown.

Do not strap it to the next finger instead.

Continue night splinting afterwards if advised.

Ask for hand therapy for fitting and for exercises afterwards.

Expect a small residual droop; that is a normal outcome, not a failure.

Where to get help

A minor injuries unit, urgent treatment centre or GP practice for assessment and splinting.

Hand therapy for splint fitting and rehabilitation.

Hand surgery for open injuries or large bone fragments.

Chartered Society of Physiotherapy for hand rehabilitation information.