A netball pass you misjudged, or a cricket ball off the fingertips. It stings, you shake it out, and then you notice the tip of your finger drooping. You can push it straight with your other hand, but as soon as you let go, it drops again.
That's a mallet finger. It's a small injury with one strict treatment rule, and how well it heals depends mostly on how carefully you follow that rule.
The tendon that straightens your fingertip runs along the back of your finger and attaches to the last bone, just past the final knuckle. In a mallet finger, that attachment is disrupted 2. The tendon has torn or stretched away, or it has pulled off a fragment of the bone it's attached to.
The classic cause is a blow that suddenly forces a straightened fingertip to bend 3. Low-effort tasks like pulling up socks can do it too, as can a finger crushed in a door 2. It's seen most often in young men in their 20s and 30s, and the middle and ring fingers are affected most often 2.
With the tendon no longer pulling on the fingertip, the joint can still be pushed straight, but it won't stay there 2. That's why the treatment is about holding the ends together, continuously, for long enough to heal.
Plenty of finger injuries in ball sports get called "jammed". The tell for a mallet finger is specific: the fingertip droops and you can't lift it on your own, even though it can be pushed straight 2. If your fingertip straightens fully under its own power, it isn't a mallet finger.
What you can't tell at home is whether bone is involved. Some mallet injuries include a fracture at the joint surface, and the size of that fragment helps decide between splinting and surgery 3.
Pain somewhere else in the hand or wrist? Try the Hand section of our Injury Finder.
The diagnosis itself is quick. After asking about the injury and your symptoms, your clinician holds the finger and asks you to straighten the tip on your own. That's the mallet finger test 6. A fingertip that sits bent and won't straighten under its own power is the defining sign 3.
An X-ray will most likely be ordered too, to look for a broken-off piece of bone and to check the joint is still lined up 6. The size of any fracture and the position of the end bone are among the things that decide between a splint and a surgical opinion 3. If there's any concern, early referral is recommended 3.
The core treatment is a splint. Your job is to wear it. Ours is to make sure the whole process works.
A Cochrane review found insufficient evidence from randomised trials that any splint type, custom-made or off-the-shelf, works better than another 4. Only a few small trials qualified, and the review dates from 2004. What guidelines stress instead is strict, continuous wear 3.
Protocols vary. One common approach is 6 to 8 weeks full-time, then 3 to 4 weeks of part-time wear, often at night 6. Others use 8 weeks full-time 1,3. If it hasn't healed by then, the splint may be needed for another 8 weeks 1.
Surgery is rarely needed 1. It's considered when a fracture involves more than 30% of the joint surface, the end bone has slipped out of alignment, a fragment can't be put back in place, splinting has failed, or the fingertip can't be fully straightened even passively 3. A 2018 systematic review found excellent outcomes with both approaches 5, and the Cochrane review found no reliable trial evidence favouring either 4. A hand surgeon makes that call.
A mallet finger follows The Well Motion Recovery Path™ with a long, quiet first phase. You move up a phase when the fingertip holds itself straight, not because a date has passed.
How long it usually takes. Full-time splinting usually lasts 6 to 8 weeks 1,3,6, then 3 to 4 weeks part-time 6. A tendon that hasn't healed may need another 8 weeks 1. For athletes, one expert review, not trial data, advises 6 more weeks of splinting at night and during sport after the first 6, with or without surgery 9. After surgery, your hand surgeon sets the timeline. Feeling normal can take several months 1.
Nothing has been tested for preventing the original knock. What has been studied is how to stop the droop coming back while the tendon heals:
See someone promptly if:
A mallet finger that's a few weeks old is still worth assessing. Fingers splinted as late as a month after the injury have still healed completely 6.
Tenderness, swelling and redness for the first few months are common, and the finger can take several months to feel normal 1. That's expected, not a setback. When the injury is treated promptly, most cases can be treated without surgery 6.
We start by listening: how it began, what makes it worse, and what it's stopping you from doing. Then we examine the area, explain what we find in plain English, and agree a plan with you. Your first visit is 40 minutes at Engadine and 30 minutes at our other clinics.
We see patients at Engadine, Mount Annan, Narellan and Appin, and at home through our mobile physiotherapy service. If you have private health cover, here's how health fund rebates work for physiotherapy.
With a splint that keeps the fingertip straight full-time for about 6 to 8 weeks, then gradual weaning and exercises 1,3,6. The tip must never bend during that time, even while you clean the finger 1.
No. The droop doesn't improve without treatment 2. The tendon ends have to be held together long enough to heal, and that's what the splint does.
The fingertip is likely to stay bent. Poor management can lead to long-term loss of function and stiffness 2, or a permanent deformity 3.
You can't tell yourself. It depends on things like the size of any fracture, whether the joint has slipped out of line, and whether splinting has failed 3. Surgery is rarely needed 1.
You can't fix it for good at home. Until you're seen, NHS advice is to raise your hand, take painkillers if you need them, and remove any rings 1. Then get it assessed and properly splinted.
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