This describes the characteristic drooping of the finger observed with injury to the extensor digitorum longus at its insertion at the base of the distal phalanx.
Most injuries are treated conservatively. A mallet finger splint is applied to hold the distal interphalangeal extended whilst permitting movement at the proximal interphalangeal joint. The splint is typically required for 6 weeks. The injury should be reviewed after the first week as frequently, a smaller splint is required once the swelling subsides.
Mallet injuries with associated fractures should be reviewed by a hand surgeon as these may require operative treatment
Old injuries may still respond to splintage. If conservative treatment fails then operative intervention may be considered if there is marked deformity or significant impairment of hand function. Part of the tendon is excised over the terminal phalanx and the joint held extended with a Kirschner wire.
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