A mallet finger happens when the tendon that holds the end of the finger straight is torn from its attachment on the bone.
The result is the same in both cases--the end of the finger droops down and cannot be straightened. With a fracture, the finger is painful and swollen around the end joint.
Treatment for mallet finger is usually nonsurgical. If there is no fracture, then the assumption is that the end of the tendon has torn off the bone, causing the end of the finger to droop. Usually continuous splinting for six weeks followed by six weeks of nighttime splinting will result in satisfactory healing and allow the finger to extend.
The key is continuous splinting for the first six weeks. The splint holds the end joint straight and allows the ends of the tendon to move as close together as possible. As healing occurs, scar formation repairs the tendon. If the splint is removed too early and the finger is allowed to bend, the process is disrupted and must start all over again.
The splint must remain on AT ALL TIMES--even in the shower.
Surgical treatment is reserved for unique cases, such as when there is a fracture associated with the mallet finger. If the fracture involves enough of the joint, it may need to be repaired. This may require attaching the fractured piece to the bone with a pin. If the damage is too severe, it may require fusing the joint in a fixed position.
Rehabilitation during and following treatment for a mallet finger focuses mainly on keeping the other joints mobile and preventing stiffness from disuse. Once the mallet finger has healed sufficiently, exercises may be instituted to strengthen the finger involved and increase flexibility.