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MALLET DEFORMITY
HAND THERAPY CARE
LEAFLET
Information Leaflet
Your Health. Our Priority.
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Outpatient Therapies | Stepping Hill Hospital
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What is a mallet deformity?
A mallet deformity is where the end joint of the finger bends down towards the palm and cannot
be straightened.
It can occur in a number of ways. The most common is when a straight finger is stubbed and
forced to bend suddenly at the joint near the tip.
As a result you can no longer straighten the finger at this joint except by lifting it with your other
hand. The finger adopts a dropped or mallet position.
This occurs when the tendon snaps. Occasionally a flake of bone may have been pulled off
where the tendon should be attached. An x-ray, if taken, will show this.
Typical mallet drop
Typical mallet
Bony mallet
In either case without the use of the tendon the finger will remain bent.
What are the signs and symptoms?
-
Pain
Swelling
Inability to straighten the end joint of the finger
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How can hand therapy help treat this?
Your finger will be placed in a plastic splint to keep it straight.
The plastic splint is then worn constantly for 6 - 8 weeks to keep the finger straight and the
tendon ends together.
Ideally, the splint must be worn all the time – day and night. This allows the two ends of the torn
tendon or bone to stay together and heal.
Without the splint the finger drops, creating a large gap in the tendon. This leads to a slack
repair and the finger remains in the dropped position.
Below is a step by step guide how to self-manage the splint. Your hand therapist will go
through this with you. It is possible you will need to change your splint/clean your finger/dry
your finger if it gets wet.
These are the items you will require to manage
your splint.
They will be provided by your hand therapist.
You will need to cut four pieces of tape.
Two will need to be 5cm and two will need to
be 10cm.
If the splint is off, your finger tip must be
supported in a straightened position at all
times. Place it on the gauze which has been
cut to size i.e. just wider than the width of your
finger
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Pull the gauze back on its self with your
other hand, so the finger and nail are covered.
Keep the tip of your finger flat on
the table. Slide the splint underneath until
the tip touches the end of the splint.
Using some scissors, trim the ends of the
gauze (top and bottom) so it’s
flush with the ends of the splint. You may
need to get someone to do this for you.
At the base of the splint use the first
piece of short tape and firmly wrap it round to
secure it to the finger.
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It should look like this when finished.
With the first piece of long tape secure it to the
base of the finger at one side. Bring it
round the front or the back and secure
it to the first piece of tape.
It should look like this when finished.
With the second piece of long tape secure
it to the base of the finger but on the opposite
side to the first piece. Bring it round the front
or back and secure it to the first piece of tape.
It should look like this when finished.
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With the final piece of short tape secure it over
the middle or bottom of the finger to secure the
tape just applied.
It should look like this when finished.
Cut the gauze away so the nail/finger
tip is visible. This is so you can keep
an eye on the nail and colour of the skin.
Bend the finger to check the tape is secure.
You should be able to bend the middle joint
freely. You may feel a slight movement at the
tip of the finger in the splint.
Treatment is most likely to succeed if the splint is:
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1.
2.
3.
4.
Worn constantly for 6 - 8 weeks.
Always taped securely in place.
Extra care is taken when changing the splint not to let the fingertip drop.
Keep it dry.
Frequently asked questions?
What should I do as I work in a wet / dirty environment?
If your hands are constantly exposed to very wet or very dirty conditions you should try to
protect them by wearing gloves.
Will my other finger joints start to get stiff and sore?
The splint is designed to interfere as little as possible with normal use of your hand.
Normal use will prevent stiffness of the uninjured parts of your finger and the rest of your hand.
What should I do if the splint becomes loose or painful?
Contact the department who fitted the splint. You may need a different size or a custom made
splint.
What happens after the splint is removed?
Your finger may be stiff so you will be given some exercises to do.
Will I need to wear the splint after 8 weeks?
If the tendon has healed you may just need to wear the splint at night or at work for a further 4
weeks. You may also be offered some soft splints for a short period.
What should I do if the splint gets wet or becomes damp?
Our advice is to dry it with a hairdryer on a low / cool setting, being careful not to burn yourself.
Or remove the splint, then keeping your finger straight, dry the finger and re-splint.
Contact us
Please contact us using any of the below details should you need any assistance or have any
queries.
Hand Therapy Team
Outpatient Therapy Department
Stepping Hill Hospital
Poplar Grove,
Stockport
SK2 7JE.
0161 419 4068
Physiotherapy.Team@stockport.nhs.uk
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If you would like this leaflet in a different format, for example, in large print, or on
audiotape, or for people with learning disabilities, please contact:
Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: 0161 419 5678
Information Leaflet. Email: PCS@stockport.nhs.uk.
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Leaflet number
Publication date
Review date
Department
Location
www.stockport.nhs.uk
OUT27
March 2013
March 2015
Outpatient Therapies
Stepping Hill Hospital
Outpatient Therapies | Stepping Hill Hospital