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 want to know what is really frustrating?
It’s that you can go weeks and weeks treating your finger, AND it can still droop! Ugh!
Unfortunately, I’ve heard this too many times to mention over my 18+ years working with people with hand injuries.
‘Why is my Mallet Finger Not Healed?’- is the number 1 question I get asked. So much that it truly warrants a blog post to answer.
I’ve listened to your frustration. And I wish I would have come across your screen sooner to save you time and worry.
Before we dive in, catch the video below to find out why your mallet finger may still be drooping.
If you prefer reading then let’s get to it.
Reason #1: It could be a Bony Mallet Finger or Tendinous Mallet Finger
Unfortunately, there is not one reason why your mallet finger may not be healed.
First, I find most people do not know what type of mallet finger they have, or go to the doctor to confirm the diagnosis.
Typically there’s a bony mallet finger where you actually avulse the tendon off with a piece of bone. It’s basically a fracture to the tip of your finger.
This results in a droopy finger.
Then there is a tendinous mallet finger. There is no fracture but only the tendon is pulled off your fingertip 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 have unless you see a doctor and get an x-ray.
Seeing a hand doctor will confirm the type of mallet finger you have.
This is important so the doctor knows how you should be splinted and for how long.
A step that shouldn’t be missed if you don’t want your future self to be asking why is my mallet finger not healed?
Reason #2: Your Fingertip was Not Splinted in the Correct Position
My second reason why your mallet finger may not be healed is because your finger was not splinted in the correct position. This piggy backs off of #1.
After your x-ray confirms the type of mallet finger you have then position of your finger in the splint 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.
There will be some stress to the tendon once you starting bending your finger. This will result in a slight droop.
Unfortunately, this is pretty normal.
This is a big reason why your finger should be splinted in hyperextension. More than likely, you won’t get a noticeable droop if you were placed in slight 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.
Even though you may be in the right position from the start, there can be a lot of reasons why you may not STAY in the correct position.
Finger swelling can fluctuate causing the splint to slide around and sometimes fall off (gasp).
This can cause inadequate healing of the tendon if this happens several times throughout the 6-8 weeks of splinting.
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 #3: You Removed your Splint Without Support
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.
This means wearing your mallet finger splint 24 hours a day, 7 days a week. Removing your splint even once, without support, can undo all that healing goodness.
Same goes with moving too quickly at the end of 6 weeks. A slow progressive program is necessary to slowly stress the tendon.
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 with a tendinous mallet, you still have to let the tendon scar and heal to the bone. Constantly removing your splint will not allow for strong healing.
Think of it this way, you would wear a cast on your wrist for 6 weeks to heal your broken wrist. Right?
Same goes for your finger.
Reason #4: You have a Swan Neck Deformity, Not a Mallet Finger
Now another reason why I find that your mallet finger may not be healed is because it isn’t a mallet finger.
Perhaps you did have a mallet finger, but it progressed into a swan neck deformity. This is very common if care was delayed however I have also seen it very acutely too.
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.
As soon as you take your splint off, your finger will droop again.
This is a common reason why mallet fingers are not healed.
Your finger could have turned into a swan neck deformity.
And if this is not caught right away, it 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!