February 10, 2017
Mallet finger > little pinkie twisted > jammed? How to cure and rehabilitate mallet finger injury
At 7 pm on 11 February 2017. I found that while washing dishes something happened to my finger. Picture below.
I iced the finger but nothing happened. So I studied google and found that I might have a problem,
At 8 pm I went to the doctor, who referred me to emergency in Austin hospital . By 12:30 am I had got an -ray done, and a doctor had seen me and said I have a mallet finger injury, He gave me a splint:
On 13 February 2017 I went to a hand therapist (Melbourne Hand therapy) who put a custom splint. Photo below. It cost me $146.
KEY: DON’T LET THE FINGER DROP EVEN ONCE!!
During this time the finger must be supported straight at all times. If the finger drops for even one second the treatment can fail.
On 2 March 2017 I went back to the hand therapist to review progress. The finger was really painful (particularly skin). The splint grinds on the middle portion of the little finger. I’ve therefore been sporadically wearing splint loose so the skin can recover. (That’s a bad idea!)
I was shown how to use the splint (I was not using it properly) and asked to come back on 30 March. There was no charge for the review of healing process.
It is important to ensure that the tip of the finger is pulled upward. That will ensure that the tendon heals as straight as possible. Else it will be too long and the tip of the finger will dangle, Unfortunately, I guess my wrong way of using the split at the critical period of the first two weeks has meant my finger tip will dangle slightly inwards.
NOTES FROM THE INTERNET REGARDING THE HEALING PROCESS:
If the finger is painful then the splint can be carefully removed and the back of the finger massaged with an alcohol swab to prevent ulcer formation.
HOW TO WASH HAND WHILE SPLINTED AND ALSO CUT THE NAILS
ISSUES WITH STANDARD TREATMENT
13 March 2017: I discovered by accident that the finger has largely healed – within four weeks. However, the tip of the finger is dangling inward.
I had two weeks to go before meeting the therapist. I started doing some preliminary therapy.
30 March 2017: Visited the therapist ($80) – she flipped the splint around (by twisting it in hot water) and showed me some simple exercises, below:
THE FINGER IS UNLIKELY TO HEAL AS IT WAS ORIGINALLY
Mallet finger can drop [Source]
Unfortunately, some deformity is common after mallet injury [Source]
KEY: DON’T FORCE THE TENDON DURING REHAB!!
After the splintage period the finger should be gently exercised. It is best to regain full bend of the finger over a period of 6-8 weeks rather than force the movement and end up rupturing the tendon again.
NOTES FOR THERAPY
Finger passive range of motion: Gently bend the injured finger with your other hand. Then gently try to straighten out the injured finger with help from your other hand. Repeat slowly, holding for 5 seconds at the end of each motion. Do this 10 times. Do these exercises 3 to 5 times a day.
Fist making: Make your hand into a fist. If the injured finger will not bend into the fist, try to help it with your other hand. Hold this position for 5 to 10 seconds. Repeat 10 times.
Object pick-up: Practice picking up small objects, such as coins, marbles, pins, or buttons, with your thumb and injured finger.
Finger extension: With your palm flat on a table and your fingers straight out, lift each finger straight up one at a time. Hold each finger up for 5 seconds and then put it down. Continue until you have done all 5 fingers. Repeat 10 times.
Grip strengthening: Squeeze a soft rubber ball and hold the squeeze for 5 seconds. Do 2 sets of 15.
KEY: DON’T RUSH INTO PLAYING TENNIS
With early movement, the ends of the tendon pull apart again, tearing the fragile protein strands.
KEY: WEAR COBAN IN THE DAY DURING REHAB + SPLINT AT NIGHT
The splint is worn for one to two weeks at night and whenever the finger might be at risk of injury. A Coban bandage is used during the day for 2 weeks.
KEY: FULL CURE CAN TAKE MANY MONTHS
There may be slight loss of full straightening at the completion of treatment, and it may take several months to regain satisfactory function. Redness, swelling and tenderness of the skin on top of the end joint are common for three or four months after injury, but usually settle eventually.