Mallet Finger is a common but often underestimated hand injury that, if left untreated, can lead to permanent deformity and loss of function. At Tran Plastic Surgery, our board-certified hand and plastic surgeon, Dr. Tuan Tran, specializes in advanced surgical and nonsurgical treatments for finger tendon injuries, helping patients restore mobility, reduce pain, and return to daily activities without long-term complications.
What Is Mallet Finger?
Mallet finger, sometimes referred to as “baseball finger,” occurs when the extensor tendon that straightens the tip of the finger or thumb is damaged. This usually happens when a forceful impact such as a ball striking the fingertip causes the tendon to rupture or pull away from the bone. As a result, the fingertip droops downward and cannot be actively straightened.
In some cases, a fragment of bone is pulled away with the tendon, known as an avulsion fracture. Although it may seem like a small injury, untreated mallet finger can lead to stiffness, deformity, and impaired hand function.
Causes of Mallet Finger
While sports injuries are the most frequent cause, mallet finger can happen in everyday life. Common causes include:
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Direct impact: A ball or hard object hitting the fingertip.
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Sudden bending: Accidentally jamming a finger against a hard surface.
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Minor trauma: Even small forces, such as tucking in a bed sheet, can occasionally trigger the injury.
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Occupational risks: Jobs that involve repetitive hand use or gripping can increase vulnerability.
The fingers most commonly affected are the middle, ring, and small fingers, though the thumb can also be injured.
For related nail trauma caused by fingertip injuries, see our onychomycosis (nail fungus) treatment.
Symptoms and Warning Signs
If you experience mallet finger, you may notice:
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Pain, swelling, and bruising at the fingertip.
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A drooping fingertip that cannot be straightened without assistance.
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Tenderness over the back of the finger joint.
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Difficulty gripping or pinching.
Seek immediate medical care if you see blood under the nail, if the nail is detached, or if the fingertip is cut deeply. These may be signs of a more severe injury involving bone or an open fracture, which raises the risk of infection.
Diagnosis: How Mallet Finger Is Evaluated
At Tran Plastic Surgery, every case is carefully examined to ensure proper healing and avoid long-term complications.
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Medical History & Physical Exam
Dr. Tran will ask about the cause of injury and symptoms, then perform a mallet finger test. You’ll be asked to attempt straightening the fingertip while the joint is stabilized. -
X-ray Imaging
X-rays are often ordered to rule out fractures or to confirm whether a piece of bone was pulled away with the tendon. If the joint is misaligned (subluxed), surgical repair may be necessary.
Treatment Options for Mallet Finger
Nonsurgical Treatment
Most mallet finger injuries can be treated without surgery. The standard approach is splinting, which keeps the fingertip straight while the tendon heals.
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Splint Use: The splint is worn continuously for 6 weeks, including during bathing and sleeping. The finger must remain in full extension; any drooping resets healing progress.
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Gradual Weaning: After 6 weeks, many patients continue splinting at night for an additional 2–4 weeks.
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Pin Placement: If keeping the splint in place is difficult, a small surgical pin may be temporarily inserted to maintain proper alignment during healing.
Though some patients may not regain full extension, splinting usually restores both function and cosmetic appearance to a satisfactory degree.
Surgical Treatment
Surgery may be required if:
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A large bone fragment is present.
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The joint is misaligned or unstable.
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Splinting fails to restore function.
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There is tendon loss requiring reconstruction.
Surgical techniques include:
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Pinning: Tiny surgical pins stabilize the bone and tendon during healing.
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Tendon grafting: Used when the tendon is severely damaged.
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Joint fusion: In rare, severe cases, fusing the joint in a straight position preserves stability and function.
As a board-certified hand surgeon, Dr. Tran has extensive experience in both microsurgical and reconstructive approaches to ensure the best outcome possible.
For patients concerned about both function and hand appearance, additional procedures such as hand rejuvenation with fat grafting or fillers can also restore balance and symmetry.
Why Choose Tran Plastic Surgery for Mallet Finger Treatment?
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Expertise in Hand Surgery
Dr. Tuan Tran is fellowship-trained in hand and microsurgery, with years of experience treating traumatic and degenerative conditions of the hand. -
Comprehensive Care
From sports-related injuries to complex tendon reconstructions, we provide both conservative and surgical solutions tailored to your needs. -
State-of-the-Art Facility
Located in Huntington Beach, CA, Tran Plastic Surgery offers modern diagnostic and surgical technology in a welcoming environment. -
Personalized Recovery Plans
Each treatment plan is customized, including follow-up therapy and rehabilitation guidance, to maximize recovery and minimize downtime.
Learn more about our broader hand surgery services.
Recovery and Rehabilitation
Healing from mallet finger typically requires 6–8 weeks with a splint or longer if surgery is needed. Physical therapy may be recommended to restore strength and range of motion.
Tips for a smooth recovery include:
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Follow splint instructions exactly. Even one lapse can prolong healing.
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Elevate the hand to reduce swelling in the first few days.
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Perform guided exercises only as directed by your surgeon.
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Avoid contact sports or heavy use until cleared by your doctor.
Living with Untreated Mallet Finger
Without treatment, mallet finger may cause:
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Permanent drooping of the fingertip.
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Limited grip strength.
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Arthritis in the affected joint.
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Cosmetic deformity.
These long-term consequences highlight the importance of seeing a hand specialist as soon as possible after injury.
Schedule Your Consultation
If you suspect you have mallet finger or recently injured your hand, don’t delay treatment. Early care leads to the best results.
📞 Call us at 714-839-8000 or contact us online to schedule your consultation today.
At Tran Plastic Surgery, Dr. Tuan Tran is dedicated to restoring hand function and helping patients regain confidence in their daily lives.
*References:
✍️ American Society of Surgery of the Hand. (2013). Mallet finger. Retrieved from https://www.assh.org/handcare/condition/mallet-finger#:~:text=A%20mallet%20finger%20is%20a,see%20Figure%201a%20and%201b).
✍️ OrthoInfo. (2020). Diseases & conditions: Mallet finger (Baseball finger). Retrieved from https://orthoinfo.aaos.org/en/diseases–conditions/mallet-finger-baseball-finger/