francois j duminy
Plastic & Reconstructive Surgeon
CAPE TOWN PLASTIC SURGEON CV
Forceful flexion of the distal interphalangeal joint (the joint nearest to the fingernail) while the patient is trying to extend the finger, can lead to rupture or avulsion (pull off the bone) of the extensor tendon.
When this happens, the intact flexor tendon's tensile force is no longer counteracted and the fingertip goes into flexion, making it look like a mallet.
If the problem is diagnosed early, the problem can often be treated successfully with a tiny splint that holds the fingertip in extension while the tendon heals.
In our experience and that of our teachers, this splinting needs to continue for no less than 9 weeks.
During the 9 week splinting period the patient cannot EVER be allowed to flex the joint.
Special instructions are given regarding splint changes and washing of the finger.
If conservative treatment fails, treatment may require inserting a pin accross the joint to stop it from flexing while the tendon heals.