Mallet finger


Possible mechanisms of injury from axial force applied to the tip of a straight digit (black arrows) causing: (top) DIP joint hyperextension (white upper arrow) and fracture, or (bottom) DIP hyperflexion (lower white arrow) and tendon lesion.
Mallet finger injury types (Tubiana classification system).
  • May be accompanied by avulsion fracture
  • Caused by forced flexion of extended DIP joint
  • If untreated, leads to swan neck deformity

Clinical Features

Finger in maximum extension
  • Rupture of extensor tendon in area of distal phalanx distal to DIP joint
  • DIP joint flexed to 40°, unable to fully extend

Differential Diagnosis

Hand and finger injuries


Mallet finger without fracture
Mallet finger with fracture at the insertion of the extensor tendon
  • Clinical diagnosis
  • Consider finger x-ray (PA and lateral) to evaluate for avulsion fracture


  • Splint DIP joint in continuous slight hyperextension x 6 wk
  • Splinting of the PIP joint is not necessary and should be avoided[1]
    • Inadvertently splinting PIP for 6 weeks results in collateral ligamentous overgrowth and functional disability[2]
  • Give an extra splint
Special Mallet finger splint (if available)


  • Discharge with hand surgery follow-up in 7-10 days

See Also


  1. Katzman B et al. Immobilization of the mallet finger: effects of the extensor tendon. J Hand Surg Br. 1992; 24(1):80-84
  2. Prosser R. Splinting in the management of proximal interphalangeal joint flexion contracture. J Hand Ther. 1996 Oct-Dec;9(4):378-86.