Why is my Mallet Finger Not Healed?
Mallet fingers are complicated. There really isn’t any other way to put it.
These little injuries can be a big pain both physically but also emotionally.
Especially when you try everything from buying every splint off of Amazon to getting 3 different doctor’s opinions.
But what the most frustrating thing about mallet fingers is that even after all the weeks and weeks of treating your finger…it can still droop! Ugh!
Unfortunately, I’ve heard this too many times to mention over my 17+ years working with people with hand injuries.
I get asked ‘Why is my Mallet Finger Not Healed?’ so much that it truly warrants a blog post to answer it. I have heard the desperation and frustration from many of you. And I wish I would have come across your screen sooner to save you time and worry.
Now before we dive in, if you prefer watching video over reading than catch the one below to find out why your mallet finger may still be drooping.
Unfortunately, there really is not just one reason, but several factors that could help you get to the bottom of why your mallet finger may not be healed.
First, if you’re not really familiar with what a mallet finger is, there’s a few different types of mallet fingers.
Typically there’s a bony mallet finger where you actually avulse a piece of the bone off with the tendon, so it’s like a fracture to the tip of the finger but it pulls a piece of the bone off with it. This results in a droopy finger.
You can also get a tendinous mallet finger where there’s no fracture, and what happens is the tendon pulled off the bone. Also resulting in a droopy finger. You can check out this blog post to learn more about What is a Mallet Finger.
There’s really no way to tell which one that you haven’t unless you do see a doctor and have an x-ray. This can help you identify which type of mallet finger you have. This is very important because you really want to make sure that you are splinting correctly for your type of mallet finger.
Reason #1: Is it a bony mallet finger or is it a tendinous mallet finger?
Another reason why your mallet finger may not be healed is because you did not go to the doctor to get an x-ray.
An x-ray will tell you which type of mallet finger you have. This is important so the doctor knows how you should be splinted and for how long.
For example, if you have a tendinous mallet finger, your finger needs to be placed in a little bit of hyper extension in your splint. This type of mallet finger injury doesn’t show up on an x-ray.
Doing this will allow your tendon to meet to the tip of the finger. The tendon has a better chance of scarring and therefore, healing.
If you have a bony mallet finger, this will show up on an x-ray. If this is the case, then your finger will not be placed in hyperextension.
In fact, it is important to make sure that you are splinted correctly with the bony mallet finger because too much hyperextension can be very painful. It also will not allow for accurate bone healing.
On the flip side, instead of hyperextended, your fingertip could be resting in the splint with a slight bend to the fingertip. If this is the case, there is a chance the fractured piece of bone may not heal.
If that is the case, your finger might not heal throughout the whole entire time that you are splinted. Then upon removal of the splint, your finger could droop.
Reason #2: Was your fingertip splinted in the right position?
My second reason why your mallet finger may not be healed is because you weren’t put in the right splint position. This is similar to what I have previously mentioned above.
The x-ray needs to come first, then the splint position can be determine.
Keep in mind, tendinous mallet fingers can result in a little bit of a droop even after splinting is done.
A droop, or lag, of 10 to 15 degrees is considered normal after a tendinous mallet finger. Because as you start moving your finger and stop wearing your splint there will be some stress to the tendon resulting in a slight droop.
This is a big reason why your finger is splinted in hyperextension. More than likely, you are not going to get a noticeable droop because you already were placed in some hyperextension in the splint.
Even if you do go to the doctor, unfortunately, I have seen situations where people are still not put in the right position.
On the other hand, your finger swelling may fluctuate causing the splint to slide around and sometimes fall off (gasp).
Even though you may be in the right position in the beginning there can be a lot of reasons why you may not STAY in the correct position throughout your whole 6 to 8 weeks of treatment.
Reason #3: Did you keep your splint on every hour or every day?
Let’s talk about reason number three why your mallet finger may not be healed. This could be because you were not wearing your splint consistently throughout the whole 6 to 8 weeks.
Or whatever timeline your doctor prescribed.
It is important to wear your mallet finger splint 24 hours a day, 7 days a week. Removing your splint even once can undo all the healing.
Just like moving too quickly at the end of 6 weeks without a slow progressive program.
If you have a bony mallet, you want that bone to heal. For that to happen, you must keep your fingertip immobilized every hour of every day.
Even if you don’t have a bony mallet, you still have to let the tendon scar and heal to the bone. Constantly removing your splint will not allow for healing.
Think of it this way, it’s no different than breaking your wrist and having to wear a cast on your wrist for 6 weeks.
You would do that, right? It’s the same thing that you have to do for your finger too.
Reason #4: Is it really a Mallet Finger or is it a Swan Neck Deformity?
Now another reason why I find that your mallet finger may not be healed is because it isn’t truly a mallet finger.
Or you had a mallet finger at one time but now it has progressed into a swan neck deformity. This is very common especially among people that have more of a chronic mallet finger.
This is why it’s so important to make sure you get the correct diagnosis. A swan neck deformity does look like a mallet finger. I have seen doctors and therapists miss this diagnosis.
A mallet finger looks like a swan neck deformity.
A swan neck deformity is way different than a mallet finger because the injury is actually happening at your PIP joint (middle finger joint).
So if your middle joint is not splinted in the correct position then your fingertip will droop. You can splint the tip of your finger for weeks and weeks but it won’t do you any good.
Because as soon as you take the splint off your finger will droop again.
This is a common reason why mallet fingers are not healed. Your finger could be a misdiagnosed swan neck deformity that was not splinted. This can be very frustrating.
The last thing you want to do is splint for what feels like forever only to see your finger drooping again.
That’s why it’s so important to make sure you know which type of mallet finger you have. And to make sure you don’t actually have a swan neck deformity.
This will ensure you get the right treatment for your injury.
Now say you’ve done everything mentioned above and that is why you are here.
You are looking for assistance on what to do, how to progress your exercise program to make you’re your finger does not droop again.
Then get the Mallet Finger On Demand Self Treatment Program here. I will walk you through how to safely progress exercises so that you can prevent drooping from coming back.
Ease your fear and anxiety today!
Get your finger started on the road to recovery.
Get the only step by step self treatment program designed by a hand therapist.