What is the prognosis of mallet finger?

Updated: Aug 27, 2018
  • Author: Roy A Meals, MD; Chief Editor: Harris Gellman, MD  more...
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An untreated mallet finger is rarely of functional consequence unless a secondary swan-neck deformity occurs. Even in those cases, patients rarely request surgical reconstruction, choosing instead to live with the injury. With this in mind, treatment of a mallet finger should not be worse than the disease. Although an untreated mallet finger may be of some cosmetic consequence, treatment that leaves a finger with improved appearance but diminished function is not ideal.

A functionally and cosmetically normal finger can be obtained with conservative treatment, as long as the patient understands the concept of nonstop extension splinting and is compliant with the care. It may take several months following completion of splinting for local swelling and erythema to subside, but thereafter, the finger’s appearance and mobility will be excellent.

Frequently, a faint residual extension lag is present, in the range of 5-10°, but is observable only on close scrutiny. Beware of the patient with naturally hyperextensible interphalangeal joints. Caution these patients at the outset that the best they can hope for is restoration of extension to neutral rather than the degree of active hyperextension observed in their adjacent digits. This loss of complete extension will present no functional difficulties and will be of trivial cosmetic consequence.

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