They are the most prevalent finger tendon injury in sport. Mallet finger. Foreign body. They may represent an isolated tendinous injury or occur in combination with … Unable to process the form. This page includes the following topics and synonyms: Extensor Tendon Injury at the DIP Joint, DIP Extensor Tendon Avulsion, Mallet Finger, Mallet Fracture, Drop Finger, Baseball Finger. Fingertip injuries are among the most common traumatic problems encountered by hand surgeons. Open injuries are generally surgically explored to evaluate for additional tendinous injury. —Mallet finger results from disruption of the extensor tendon at its insertion site at the dorsal aspect of the distal phalanx base, and mallet finger is the most common finger tendon injury in sports . (2010) ISBN:0781793777. This 62 year old male presented to the Emergency Department after a fall. Observe skin color, warmth, and capillary refill to assess blood flow, Evaluate sensation to light touch and two-point discrimination to assess integrity of the digital nerves, Inability to extend the distal phalanx actively, Most tenderness to palpation over the dorsal distal phalanx and DIP joint, Possible compensatory swan neck deformity, Possible subungual hematoma (blood under the nail plate). 22 (2): 237-56. One such injury, which involves disruption of the extensor mechanism at the level of the distal interphalangeal (DIP) joint, is commonly referred to as a mallet, baseball, or drop finger. Mallet finger. 47.1), and oblique views. Chronic injury can result in swan-neck deformity (hyperextension PIP) Chapter 10 - Extensor tendon injuries. Trigger finger; We take a multidisciplinary approach to treatment, getting input from all of the medical areas that are involved with your care. The bony mallet finger refers to the avulsion fracture at the phalangette basilar part caused by traction of the extensor tendon when the original trauma occurs, leading to a limited extension of the distal phalanx. A mallet finger injury results from a lesion of the bony or ligamentous attachment of the extensor mechanism to the distal phalanx. Emergency radiology, imaging and intervention. Mallet finger injury X-ray. 2. The team at Orthopaedic Associates of Michigan (OAM) includes both orthopaedic and plastic surgeons who are fellowship-trained in finger, hand, wrist, elbow, and shoulder procedures. (2014) HAND. There is generally pain and bruising at the back side of the farthest away finger joint. Mallet finger is an injury to the tip of the finger when something hard, like a baseball, jams it. The extensor tendon is damaged (possibly ruptured). -Definition: A mallet fracture is an “avulsion fracture of the distal phalanx with a bone fragment on the terminal extensor tendon, resulting in unopposed flexion and the inability to actively extend the distal interphalangeal (DIP) joint.” Radiographics. (2007) ISBN:354026227X. Radiographics. A bony mallet has an associated fracture of the dorsal base of the distal phalanx involving the insertion of the extensor tendon. Wieschhoff GG, Sheehan SE, Wortman JR et-al. In sports, they are caused by high-velocity balls that strike the dorsal surface of the DIP joint while it is flexed. Finger radiographs to obtain include posteroanterior, lateral (Fig. The mechanism that straightens the DIP joint is disrupted. Mallet finger radiology tests will be able to determine whether or not you need surgery to repair the finger. Win an All-Access Pass! The opposite of a mallet finger is a jersey finger. 2016;36 (4): 1106-28. ... Radiology 1996; 198:219-224. Sometimes, the tendon itself tears rather than avulsing the bone fragment, in which case … A high proportion of mallet finger injuries will present as isolated tendon injuries without any associated avulsions fractures known as a "mallet fracture" 5. A mallet finger is an injury to the extensor mechanism of the finger. baseball, basketball), or a crush injury (slamming a door towards the distal interphalangeal joint) in the extensor direction. In the workplace setting, mallet finger injuries are usually caused by crush injuries or from falling objects. There is a corresponding defect in the phalangeal base. This injury is caused by hyperflexion of the distal interphalangeal joint, resulting in avulsion of the attachment of the extensor tendon from the base of the distal phalanx. Mallet injuries may occur with or without an avulsion fracture at the DIP joint. This positioning causes approximation of the injured tendon ends, which usually heals by scarring over time and restores extension 7. Injury to these structures commonly results from direct axial or flexion loading of the DIP joint, as can occur by direct blow from a ball. These injuries result when traumatic forced flexion of the extended fingertip causes disruption of the distal extensor mechanism. 9 (2): 138-44. fractures involving a single facial buttress, Meyers and McKeevers classification (anterior cruciate ligament avulsion fracture), Watson-Jones classification (tibial tuberosity avulsion fracture), Nunley-Vertullo classification (Lisfranc injury), pelvis and lower limb fractures by region. The dorsum of the joint may be slightly tender and swollen, although there may be little pain. Hover on/off image to show/hide findings. A patient with a jersey finger is not able to flex his or her finger at the DIP joint. 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