Commonly known as a “droopy” finger, a mallet finger injury is when your finger extensor tendon is damaged or injured in some way. This extensor tendon is responsible for straightening the tip of your finger. Unfortunately, when the tendon is injured, usually by a cut or break, you are unable to lift the tip of your finger straight.
When trying to understand this small but mighty injury, it is important to understand there are two types of mallet finger injuries. These are commonly known as a bony or tendinous mallet.
Bony mallet finger
A bony mallet finger is when you avulse, aka tear, a piece of the bone off of your distal phalanx. Basically, it is a fracture because your tendon pulled a small piece of the bone off of your fingertip. A bony mallet finger is often painful because, technically you broke your fingertip.
Look at it this way. If you have to have one of these annoying little injuries then the bony mallet finger is usually the better one to deal with. This is because the healing process is pretty straight forward.
Bone heals better to bone.
With a bony type, the small piece of bone that is broken off will heal back to the distal phalanx of your fingertip. Typically, this requires you to wear a splint to keep your mallet finger straight for about six weeks. This allows the fractured bone to heal.
Tendinous mallet finger
A tendinous mallet finger is when your tendon is completely pulled off the bone without pulling a piece of the distal phalanx bone off. Typically, you won’t have a fracture or broken bone associated with this type. One of the only benefits is that you may notice minimal to no pain. In fact, I’ve heard from clients that say they didn’t even know they injured their finger until they looked down at their finger.
Since just the tendon was pulled off the bone, you are now left with a torn tendon that somehow has to heal back to your distal phalanx.
Unfortunately, the tendinous type does not win the trophy for best of mallet finger.
As you can imagine, healing tendon to bone takes longer to heal. This can be very frustrating when you are dealing with the lengthy healing process. Like I said before, bone heals better to bone. It is way more difficult for your tendon to heal to bone.
So the healing process relies on scar tissue build up. I like to use the analogy of glue. Your body builds scar tissue- aka glue- at the insertion of the tendon. That in combination with wearing a splint 24/7 will let that tendon stick with the help of the glue. However, this will only happen if you consistently wear your splint for 8 WHOLE weeks.
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