Boutonnire Deformity. This will take about 1 to 2 hours. 8% (95/1163) 3. Remember to take your pain medications as prescribed, wear your splint for a minimum of six weeks as instructed by your provider, and do your finger exercises. The joints sit in volar plates (collateral ligaments attached to dense fibrous connective tissue), which provide joint stability.2,3. A tendon is like a rope made up of collagen (protein) fibers that attach your muscles to your bones. 2018;6:e5763. Central slip extensor tendon injury (may cause a boutonnire deformity over time), Tender at dorsal aspect of the PIP joint (middle phalanx). Blood can collect beneath the nail, and the nail can even become detached at the base. The carpal bone that connects to the thumb's MCP joint is the trapezium. An open mallet finger starts with a sharp cut or laceration, which goes through the tendon and down to the bone, over the last joint of the finger. The extra finger or toe might be a small nub or extra tissue, or it might be a functioning digit with nerve endings, joints, and bone. A low threshold for referral should exist for collateral ligament injuries in children, because the growth plate often is involved. A dorsal PIP dislocation is the most common type of finger dislocation. All on-field evaluations must be readdressed in the office for a more thorough examination including radiography. The most common type of splint used is a plastic stack type. After that, youll wear the splint only at night for another two weeks. If there is instability or significant rotation, referral to a hand surgeon is required. Harvard Medical School. If a bone fragment is also detached, its called an avulsion fracture. A power grip can help lift large or heavy objects, whereas a precision grip is useful for holding smaller, more delicate objects. Furthermore, the use of surgical wires (i.e., fixing the affected joint in a neutral position by drilling a wire through the DIP joint to the PIP joint) did not improve clinical outcomes.14,15 Figure 3 describes different types of splints. In the absence of indications for referral, mallet finger (with or without an avulsion fracture) can be effectively treated with strict immobilization. Evidence suggests that splint usage dates back to 1500 B.C. Distal finger extensor tendon avulsion leading to Mallet deformity are splinted in extension WET Wet plaster/fiberglass material (not the padding) Plaster of Paris and water create an exothermic reaction. Stay in contact with your healthcare provider and let them know about any additional problems or concerns. Intra-articular fractures are often complicated and unstable and should be referred to a hand specialist.3 Extra-articular fractures may be nondisplaced or displaced. It usually involves injury to the volar plate and may include a volar plate avulsion fracture. JAMES R. BORCHERS, MD, MPH, AND THOMAS M. BEST, MD, PhD. Patients typically present with a deformity, swelling, and bruising with loss of function. Rotation is assessed after a finger fracture by active flexion; there should be no digital overlap. Content is reviewed before publication and upon substantial updates. All Rights Reserved. A simple technique for injecting the small joints of the fingers and thumb using finger traps for traction. That rubbing will cause joint inflammation, pain, and stiffness. American Academy of Orthopaedic Surgeons. Splint the PIP joint in full extension for six weeks. Traditional treatment following reduction of uncomplicated dorsal PIP joint dislocations is splinting for one to two weeks followed by buddy taping for another one to two weeks. Advertising on our site helps support our mission. Web70-90 degrees. Clinical examination alone cannot diagnose fractures, and treatment protocols depend on radiography results. Sometimes, the tendon can rupture from only a little force exerted at just the wrong angle. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. If the skin blanches, the DIP joint is overextended. A delay in proper treatment may cause a boutonnire deformity (flexion of the PIP joint coupled with hyperextension of the DIP and MCP joints) (Figure 6). Usually, this is due to a poorly aligned joint fracture. (2012). There are several types of splints. If there isnt a bone break, the bone can be put back in place without surgery using a technique called reduction. When conditions like RA and PsA affect the digits of your hands, treatment starts with managing the source of those symptoms. Stuart Hershman, MD, is a board-certified spine surgeon. Youll still be able to use your hand. Within the finger joints is a fibrous capsule lined with synovium, a thin membrane that secretes fluid to lubricate the joints. Disruption of the flexor digitorum profundus tendon, also known as jersey finger (Figure 4), commonly occurs when an athletes finger catches on another players clothing, usually while playing a tackling sport such as football or rugby. American Society for Surgery of the Hand. The goal is to keep the fingertip straight in the splint until the tendon heals. DIP joint extension splinting for 6 weeks. On each finger and the thumb, a metacarpal bone connects to the proximal phalanx. Your hand surgeon will help recommend the proper treatment that is specific to you. In children, the fracture may happen in the growth plate of the distal phalanx. Dorsal dislocation of the proximal interphalangeal joint is the most common type of finger dislocation. Related letter: Proper Technique for Reduction of Metacarpophalangeal Dislocations. 2012 Apr 15;85(8):805-810. In children, the fracture may be in the growth part of the bone. While surgery may be necessary such an injury may heal if placed in a finger splint. Successful relocation produces immediate relief of discomfort and resolution of the deformity. Copyright 2022 American Academy of Family Physicians. 1% (30/3970) 5. WebMallet Finger Sagittal Band Rupture indicated in symptomatic patients after failing several months of splinting and activity modification. Discuss with your doctor and a specialist whether surgery is necessary for your finger to regain its function. Distal sensation should also be evaluated. You may find yourself unable to completely straighten your finger, and it may droop at the top. It can be longer if you dont keep to the splinting routine as directed. Both types of syndactyly affect the movement of and the ability to bend the finger joints. Some situations may require surgical intervention. Injuries with even a little swelling or bruising may have a fracture.X-rays or ultrasound images can be used to show if there is a fracture causing the finger deformity. Mild cases of trigger finger can be managed by resting the affected finger(s) or thumb and limiting or avoiding activities that cause symptoms. Reduction is similar to that of a dorsal PIP dislocation if no concomitant injury is present. WebPatients with mallet finger present with pain at the dorsal DIP joint; inability to actively extend the joint; and, often, with a characteristic flexion deformity. Copyright 2022 American Academy of Family Physicians. Syndactyly is webbing or fusion of the fingers or toes. These injuries should be suspected with gross deformity on inspection of the middle or proximal phalanx. acute soft tissue injury A 27-year-old male presents with finger pain 2 days after suffering an injury while playing basketball. When any part of your hand is not working properly, daily activities like bathing, cooking, doing your job, and caring for children become harder. Mallet finger is an injury and is unrelated to arthritis. WebAbout Our Coalition. Your fingers have two long flexors, which are located on the underside of your forearm. These fractures are caused by an axial load to the tip of an extended finger, leading to forced flexion at the DIP joint.11 A mallet fracture includes a bone fragment attached to the terminal extensor mechanism (Figure 4). You may develop a problem where your finger has a swans neck shape. If you dont treat your mallet finger injury, your finger could become stiff and even unbendable. Mild to moderate finger sprains and dislocations are usually treated with rest, ice, compression, elevation (RICE), and splinting. Radiography may demonstrate an avulsion fracture at the ligamentous insertion point. Partial or minimal tears of the UCL are treated by covering the thumb in a cast for up to four weeks, followed by a removable splint that needs to be used until movement and stability are restored. Radiography is needed to evaluate intra-articular involvement because injuries involving greater than one-third of the joint surface require referral for possible surgical repair. Your thumb also has flexors, along with a long flexor and a short flexor. Your thumb has two extensors in the forearm. A dislocation can occur when the finger joint is pushed out of its alignment. The finger can become deformed if the injury is left untreated.17. Finger fractures and dislocations are commonly seen in the primary care setting. Thank you, {{form.email}}, for signing up. The medicine works by reducing the swelling in the finger, which can help it move better. Anatomy of the hand. Each finger contains three phalanges (proximal, middle, and distal), and the thumb has two phalanges. Volar plate injury (usually at the PIP joint), Maximal tenderness at the volar aspect of involved joint. Immobilizing the finger with a splint helps promote natural. Our website services, content, and products are for informational purposes only. When hand or wrist pain may mean arthritis. Another interesting feature of the finger joints and hands is the ability to grip all types of objects. The role of morphology of the thumb in anthropomorphic grasping: a review. Patient information: A handout on this topic is available at https://www.aafp.org/afp/2006/0301/p839.html. If active extension is present, splinting can be limited to when the patient is sleeping and during athletic events for another six weeks. If left untreated, RA can cause deformities of the hands and fingers and make it harder to use your hands. Biceps tendinitis is a painful condition, but it can be treated, and sometimes taping helps. Jersey finger deformity. Patients typically present with a deformity, swelling, and bruising with loss of function. Allowing the skin to breathe for 10 to 20 minutes between splint changes minimizes the risk of maceration. Let's discuss the details. Use your other hand to hold down (block) the middle joint of the injured finger. Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease caused by an overactive immune system that primarily attacks the joints. Your thumb can perform different movements. Radiographs may show an avulsion fragment at the base of the involved phalanx. The injury may affect the cartilage in the finger that controls bone growth. This forceful extension leads to an avulsion fracture at the site where the flexor digitorum profundus tendon attaches to the volar base of the distal phalanx.5 Although flexor digitorum profundus avulsion fractures can occur in any finger, they most commonly affect the ring finger. This gives the finger the appearance of a mallet or hammer. Example of mallet finger with drooping of tip. Lana Barhum has been a freelance medical writer since 2009. Occasionally, boutonnire deformities occur acutely. Their function is essential for grasping and manipulating objects and performing intricate tasks. Treatment should restrict the motion of injured structures while allowing uninjured joints to remain mobile. Your forearm, which is made up of the ulna and radius bones, extends from your elbow joint to your hand. In sports, any direct hit to your extended fingers from a baseball (or football, basketball, or volleyball) can rupture the tendon that straightens the tip of your finger. Most complications result from lack of adequate treatment that doesnt appropriately immobilize your finger. A more recent article on common finger fractures and dislocations is available. If splinting is not started for several weeks after injury, the result is less satisfactory but can still be successful.Your surgeon or hand therapist will provide instructions on how to wear the splint. Wang T, et al. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Keep reading to learn more about your finger joints, including their structure, associated conditions, and treatment for those conditions. Splint finger and refer to orthopedic or hand surgeon. Ice the finger for 10 to 20 minutes, and then remove it from the ice pack. Tuft fracture (Figure 3) is the most common type of distal phalanx fracture. Treatment following simple reduction is also similar to that following PIP dislocation. If you can't move it or begin to lose sensation in the finger, call your doctor. Fascia blasting has become a popular technique for loosening the fascia and treating conditions like pain and cellulite. The thumb offers a couple of unique features that your other digits do not. The tendon requires a graft of tendon tissue from someplace else on your body. Radiography (commonly anteroposterior, true lateral, and oblique views) is required in the evaluation of finger fractures and dislocations. primary central band repair. This x-ray of a mallet finger shows a broken finger, where a piece of the bone has been broken off. Patients with PIP joint injuries may continue to participate in athletic events during the splinting period, although some sports are difficult to play with a fully-extended PIP joint. WebTherapeutic Value of Using Two-step Splinting for Mallet Finger Saito Kazuo, Kihara Hitoshi Asian Journal of Occupational Therapy 12(1) 23-28 2016 Most mallet fingers are an injury to the tendon itself, but in some cases, the tendon may pull off a small fragment of bone from the finger bone. Extensor tendon injury at the DIP joint (mallet finger). If extensive loss of motion persists, referral is recommended. WebMallet Finger Sagittal Band Rupture Carpal Trauma An 18-year-old rugby player has had pain in his ring finger after missing a tackle 1 week ago. Mallet fingers can happen when an object (such as a ball) strikes the tip of the finger or thumb. Continued pain and repeated injuries are more likely due to a problem in the joint. After the pain of the initial injury you may experience: No. Its important to fully comply with the splinting routine. Tenderness over the dorsal aspect of the middle phalanx will be present. In some cases, you might need surgery, including to treat fractures and torn tendons. Or it may pull the tendon away from the fingertip bone (distal phalange). doi:10.7717/peerj.5763, Nanayakkara VK, Cotugno G, Vitzilaios N, et al. Ann R Coll Surg Engl. The assessment should also include finger alignment, ligament integrity, neurovascular status, and flexion and extension of the joints. American Society for Surgery of the Hand. Physicians should advise patients with mallet finger not to flex the DIP joint during treatment; the splinting period must restart every time flexion occurs. Wrap an ice pack in a towel or paper towel and press it against the injured finger. The distal phalanx should be supported during splint changes.16 This is difficult to achieve alone, and the patient may need to return to the physicians office for splint changes. Bend that joint, keeping the splinted part of your finger straight. Policy. 2016;98(5):343-344. doi:10.1308/rcsann.2016.0110. Treatment for conditions that affect the finger joints is based on the cause and symptoms. Maximal tenderness will be located at the volar aspect of the affected joint. It is important to isolate the DIP joint during the evaluation to ensure extension is from the extensor tendon and not the central slip. Examples of conditions that cause finger and finger joint defects include polydactyly, syndactyly, and cleft hand. The absence of full passive extension may indicate bony or soft tissue entrapment requiring surgical intervention.4,7,10 Bony avulsion fractures are present in one third of patients with mallet finger.11,12. Trigger finger is a type of repetitive stress injury that can affect finger and thumb joints. The PIP joint usually is affected, and collateral ligament damage often is present. nonsteroidal anti-inflammatory drugs (NSAIDs), orthodoc.aaos.org/cedarvalleyhand/malletfinger_presentation.pdf, assh.org/handcare/hand-arm-conditions/mallet-finger, orthoinfo.aaos.org/en/diseases--conditions/mallet-finger-baseball-finger/, bssh.ac.uk/patients/conditions/28/mallet_finger_injury#What_is_the_treatment, nlg.nhs.uk/content/uploads/2016/12/IFP-0925.pdf. Stiffness lessens with movement and use of the affected finger joints. Surgery may also be considered if wearing a splint is difficult or was not previously successful. Stability of the reduction is assessed by gentle active flexion of the involved finger; the joint should be stable through flexion and extension. can get it. She admits to improved overall pain but increased weakness. If the joint involved (the distal interphalangeal) is allowed to flex during the six weeks, youll have to begin the splinting process again. Table 1 summarizes the evaluation and treatment of common ligament and tendon injuries. The finger bones are named by how far they are from the rest of your body. J Hand Surg Eur Vol. Leversedge FJ, Jennings CD. Treatments that are sometimes used for people who have sustained a fracture include casting, splinting, or surgery. Basic knowledge of the anatomy of the finger and a thorough evaluation of the patient can ensure proper diagnosis and treatment. Stabilization is often achieved with splinting. DOI: Griffin M, et al. Finger and metacarpal fractures are the most common sports-related fractures in adults and adolescents.1,2 If not treated properly, finger fractures and dislocations can have significant consequences, including poor function, chronic pain, stiffness, and deformity.3 The goal of management is return to normal function and activity. Mallet finger can be treated non-surgically by applying a specially designed splint for 6-8 weeks. Insights into the pathogenesis and treatment of split/hand foot malformation (cleft hand/foot). Problems with the finger joints can occur from different types of injuries. The most common treatment for trigger finger is an injection of a steroid called cortisone. concomitant splinting and/or NSAIDs after steriods injection does not improve outcomes. Describes the bent-down (flexed) position of the middle joint of the finger. But it can also occur when performing household activities if you strike the tip of a finger on an immoveable object such as a door or wall. PeerJ. Your doctor will likely see you a week after the splint is put on to assess how the finger is healing. If relocation of the joint is unsuccessful or if the joint remains unstable following reduction and subsequently dislocates again, the injured finger should be evaluated using radiography. Assessment of stability is necessary for appropriate management of dislocated joints. You should also ice your splinted finger for 10-20 minutes three to four times per day. Surgery involves widening the spaces around the tendons of the affected finger(s) or thumb. Despite proper treatment of mallet finger, permanent flexion of the fingertip is possible. Increasing the extension of a dorsal aluminum splint weekly will progressively increase range of motion.22 In less severe injuries, the injured joint should be buddy taped. Getting a grip on hand osteoarthritis. All fingernail beds should point toward the thenar eminence. Options may include a mastectomy, chemotherapy, radiation, or removal of skin lesions. Treatment for Pagets disease depends on the type. Mallet finger injuries are usually treated without surgery, unless the injury is chronic. In these cases, wires or small screws are used to realign the joint (see Figure 4). Once it becomes arthritic, you will need surgery to repair the damage. A physical examination is crucial in the assessment of finger injuries. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Mallet fractures (mallet finger) occur at the insertion of the terminal finger extensor mechanism into the dorsal portion of the distal phalanx. This is part I of a two-part article on finger injuries. Damage to the tendon occurs when a hard ball (that youre trying to catch or field) hits your fingertip. Because of the risk of tendon retraction and the need for surgical treatment, patients with flexor digitorum profundus avulsion fractures should be referred to a hand specialist. When faced with an emergency injury such as a broken leg, a homemade, If youve injured your finger, you may wonder whether its jammed or fractured. The evaluation of finger injuries during an athletic event differs from an evaluation in the office. Osteoarthritis. None has proven to be superior to the others. Treatment for OA of the hand and finger joints can help ease pain and improve the use of affected joints. To treat the pain and swelling of a mallet finger immediately: Its a good idea to see a doctor as soon as you can. But you may develop arthritis if the tendon pulls off a piece of bone from the joint surface and it remains displaced. This might include a joint fusion, where the surgeon removes the damaged part of a joint and the bones are fused. During this time, the splint may be carefully removed to allow for cleansing of both the splint and the finger, but you should avoid strenuous activities and sports to prevent recurrent injury. Does Fascia Blasting Work and Is It Safe? Once a fracture has been identified, the proper treatment must be undertaken. If the bone fragment is large enough, it may require surgical treatment to prevent joint problems from developing. Finger fractures involving greater than 30 percent of the intra-articular surface should be referred to an orthopedic or hand surgeon. Current concepts: Mallet finger. Finger, hand, and wrist injuries. The hand can be elevated (fingers toward the ceiling). he has had ulnar-sided wrist pain, decreased range of motion, and periodic clicking in his wrist. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. You can do your best to avoid mallet finger injuries by being careful when you play sports that use a hard ball. Stable nondisplaced fractures can be treated conservatively with buddy taping and early range of motion, but should be followed carefully to ensure stability of the fracture. Youll need to know if the tendon was torn, if it detached from the bone or if theres a fracture. Your healthcare provider might also recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to manage the pain associated with the injury. Once the mallet finger has healed, your surgeon or hand therapist will teach you exercises for the small end joint as it becomes very stiff from the splinting. With complex syndactyly, the bones may be fused, along with blood vessels, nerves, and other soft tissues. Bicep tendonitis is common from everyday wear and tear on your joints. The hardware is removed once the finger has healed. They enable you to perform most of the activities you do daily. At the carpometacarpal joint, the thumb joint can perform the following movements: At the MCP joint at the base of the thumb, the following movements can take place: At the IP joint of the thumb, the thumb can bend to the base of the thumb and away from the base. One hand is made up of about 27 bones, and 14 of those are in your fingers. Cohort trials with similar clinical outcomes, Primarily expert opinion in clinical reviews, Primarily expert opinion and positive trends found in clinical outcomes of reports (case series, smaller randomized controlled trials), Splint with DIP joint in full extension for 4 to 6 weeks, Open fracture (consider with subungual hematoma), Dorsal avulsion fracture or extensor tendon rupture (mallet finger), Axial load injury while DIP joint is in extension (forceful flexion), Splint with DIP joint in full extension to slight hyperextension for 8 weeks, Flexor digitorum profundus avulsion fracture (jersey finger), Injury caused by forceful extension of the DIP joint when in a flexed position, Expedited referral for surgery (may splint with proximal interphalangeal and DIP joints in slight flexion until surgery evaluation), All flexor digitorum profundus avulsion fractures require referral for surgery, Contractures of the flexor digitorum profundus (flexion deformities), Repeat radiography in 7 to 10 days to evaluate for alignment, Malunion (includes malrotation and rotation), Immediate, unlimited access to all AFP content, Immediate, unlimited access to this issue's content, Immediate, unlimited access to just this article. The primary function of these muscles is to straighten out the fingers. A tongue depressor or a clean popsicle stick can be taped to the bottom or top of the finger across the joint temporarily to keep it straight. The cartilage helps them to move gently against one another. You should go to the emergency department when you get injured. Normally, a splint will be worn at all times for about eight weeks (see Figure 3). DIP joint should be isolated during the examination. Your primary healthcare provider may be able to treat your mallet finger. The neurovascular evaluation should include two-point discrimination and capillary refill assessments. A boutonnire deformity usually develops over several weeks as the intact lateral bands of the extensor tendon slip inferiorly. Examples include scrubbing dishes and bumping an object when putting clothes into a drawer. This happens when an extensor tendon has been cut or torn from the bone. Following reduction of a proximal interphalangeal dislocation, short-term splinting in flexion with early active range of motion and strengthening is preferable to prolonged immobilization. Dislocations of the DIP joint are often associated with trauma and may have associated fractures and soft tissue injury.7 A simple dorsal DIP dislocation should be evaluated with radiography to assess for fracture. Dislocations are described as dorsal, volar, or lateral depending on the direction of the middle phalanx to the proximal phalanx. A local joint block can be considered if significant pain impedes reduction. Coming to a Cleveland Clinic location?Cole Eye entrance closingVisitation, mask requirements and COVID-19 information. Take over-the-counter pain medications, if needed. The bone closest to your palm is the proximal phalanx. Part II, Fractures, Dislocations, and Thumb Injuries appears in this issue of AFP. We do not endorse non-Cleveland Clinic products or services. These fractures are commonly classified as intra- or extra-articular. The inability to flex or extend the joint, loss of distal sensation, and complex fractures warrant evaluation by an orthopedic specialist.. The injury causes forced extension of the DIP joint during active flexion. The possibility of concomitant fracture or soft tissue injury must be considered, especially if relocation is unsuccessful. Healthline Media does not provide medical advice, diagnosis, or treatment. Mallet finger is an injury. Last medically reviewed on December 11, 2018. But even delayed treatment with splinting can be successful. Referral criteria include an unstable joint or a large avulsion fragment. There are two types of mallet finger. In some cases, when the splinting routine is difficult, the doctor may insert a temporary pin to hold your joint straight for the eight-week healing period. This fracture at the fingertip is often associated with a crush injury. With this condition, the digits do not separate in the hand or foot. To evaluate suspected finger fracture or dislocation, anteroposterior, lateral, and oblique radiography should be performed. After six weeks of splinting, the joint should be reexamined. This content is owned by the AAFP. If a mallet finger is left untreated, your finger can become stiff. Distal phalanx fractures are stable and can be treated with simple splinting of the DIP joint only. All splints for mallet finger achieve similar results. A Cochrane review15 showed that patient compliance is the most important factor in the success of splint treatments. Polydactyly means having extra fingers or toes. Differential. A mallet finger is an injury that should be treated, but you should be able to go about your daily life. (2012). This might include: When treatments havent worked and OA makes it harder to use your hands and fingers, your healthcare provider might recommend surgery. Mallet finger, trigger finger or trigger thumb, swan neck, boutonniere deformity, or broken fingers : Arthritis, mallet finger, swan neck, trigger nger or trigger thumb, hyper- exible, and crooked fingers : Provides targeted support to the base of your thumb to reduce the everyday pain of CMC arthritis : Great For If there is good positioning of the bone fragments, new bone will fill the gap. The ring finger is the weakest finger and accounts for 75 percent of jersey finger cases.18 The injury can occur if the force is concentrated at the middle phalanx or at the distal phalanx. All rights reserved. They insert with tendons to the phalanges of your fingers. Patients with collateral ligament injuries may continue participating in athletic events as symptoms allow. Cleveland Clinic. The typical treatment involves splinting and ice. An inability to straighten your fingertip. Tendons attach your bones to your muscles, providing stability and motion. The extensor tendon may be stretched, partially torn, or completely ruptured or separated by a distal phalanx avulsion fracture.9, Patients with mallet finger present with pain at the dorsal DIP joint; inability to actively extend the joint; and, often, with a characteristic flexion deformity. Mallet finger is also called drop finger. Treatment and Recovery for a Smashed Finger. WebTENS is not reasonable and necessary for the treatment of Chronic Low Back Pain (CLBP) under 1862(a)(1)(A) of the Social Security Act. In some cases you may injure your finger bone along with your tendon. With cleft hand, movement of the finger joints can sometimes be restricted. Verywell Health's content is for informational and educational purposes only. The benefits of early range of motion following relocation of a dorsal PIP dislocation are debated. DOI: Cheung JP, et al. If the PIP joint is injured, the patient will be unable to actively extend the joint; however, passive extension should be possible. Part I of this two-part article focuses on common tendon and ligament injuries of the finger. Review of acute traumatic closed mallet finger injuries in adults. Your fingers move freely, with the four fingers allowing you to bend and stretch in one direction. Part II, Fractures, Dislocations, and Thumb Injuries. Sometimes, mild drooping of the last joint in all the patients fingers is seen normally in some people. 2022American Society for Surgery of the Hand. There are many types of splints available. Protected early motion (within 1 week as allowed by pain and swelling) is encouraged after dorsal dislocations of the proximal interphalangeal joint. Typically, the finger regains acceptable function and appearance with this treatment. The second type is a broken bone at the extensor tendons attachment site that prevents the tendon from pulling on the whole bone. 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