great video, thank you. I did a ligamentous mallet to my right pinky, then 2 weeks laters a ligamentous mallet to my left middle finger. I'm 1 week away from splint removal but the local hand therapists are completely booked out. Thanks for the advice on stiffness exercises.
Your video and the questions and answers are very helpful indeed. I had to wait 6 weeks before I saw the doctor after catching my finger in the car door. He diagnosed it as a mallet finger that was too late to splint. Once I knew what the injury was I was in a position to check out possible solutions. I now have a custom splint applied and into my 2nd. week. I’m hopeful that after the recommendation of keeping it on for 8 weeks that it will be on the mend. With the additional information gleaned from your video I am in a better position to see the treatment through to the end. Thanks. Selina
Hi Selina, good to hear you are getting the right treatment now. Definitely not too late at 6 weeks - I have even seen good results occasionally when there have been a few months of no treatment, though the odds of a good outcome certainly decrease. Here's to an excellent recovery for your finger! Cheers
Just got my dorsal splint off today after 9 weeks and they moved me to a stack splint for heavy lifting and sleeping. This video was really informative and positive. Thanks!
How is your finger..I'm on week 6..how do I know how long to keep splint on....is it better to go longer or to take off splint and see... I dont want to disrupt my healing process..
Hello Sasha, that's a really tricky one... I don't know of any research or evidence looking into it, and my own experience only extends to mallet fingers up to 12-18 months post injury. What I have found is that the rate of successful outcomes seems consistently high for several months post-injury, then starts to decrease. I have occasionally had good outcomes with patients whose injury was >12 months before, but far from guaranteed. I suspect that after 5 years the injured tendon (or bone) has essentially stopped trying to heal, and has 'settled in' to its new normal. There is not much reason not to give it a go (it will be a bit annoying for 6-8 weeks, but nothing worse than that), but I do not feel very hopeful. If you try it and prove me wrong, please let me know! All the best, - Ian
Great informative video. AAfter 8 weeks of splinting and 2 weeks of hand exercises, the initial finger was straight but has slowly drooped to around 20 degrees. After all this time, is it worthwhile to re-splint?.
Not as long as it's functional. If you ask why, you may gain not the same functionality after another surgery. The small bending is normal as your finger won't ever be the same as before. 20degrees is still fine with functionality.
Really informative video. Thank you! You say that a lag can start to appear after removing the splint when you start moving your finger, as a result of doing too much too soon. I believe this is due to the tendon stretching. Is this still possible if you had a bony mallet finger instead? Or is there a much lower chance of a lag appearing due to exercises? I'm in my exercises phase now and am wary of doing too much.
Hi Sam, glad you found the video helpful. You are right, the lag is due to the healed tendon ending up longer than it was before the injury. This may be due to poor positioning of the fingertip in the splint, or from the tendon 'stretching' a bit during the exercise/rehab phase, but it can sometimes happen anyway, even when the patient has been super careful and done everything right. It is definitely more common when there is a tendon injury with no fracture involved, but bone healing isn't always perfect either, and we sometimes see a lag after a bony injury. It is sensible to be cautious during this phase of splint weaning while you get the fingertip moving. I hope your finger makes a fabulous recovery! Cheers - Ian
Thank you for the clear video! I have injured my left pinky finger in December due to a volleyball accident. The physician diagnosed it with an X-ray to be a bony mallet finger and fixed it into a slight hyperflexion position with a splint. I wore it for a little more than 6 weeks and after finally being allowed to take it off, have a little splint for night and activities, started exercises. Now 8 months later there is still a drooping of 12%, by the hand therapist said as normal, but also a big bump has formed on top of the DIP joint that is preventing me to fully bend the pinky and it also looks not very pretty. I can't find any information about the bump, is this scar tissue, a bony bump, fluid buildup, will this disappear after more months? Will splinting it again help? The drooping does not bother me very much, but the bump is so frustrating and ugly! If anyone can let me know if something can be done about the bump, would be very appreciated!
Hi Dorien, what you describe is really common after almost any kind of finger injury. The way the body heals is always a bit of an over-reaction in the early stages - throwing together a heap of collagen fibers (in the case of ligament or tendon injury) or new bone tissue (in the case of a fracture) with the focus on speed rather than neatness. Some bulkiness and thickening at the repair site is basically normal (varying from person to person, of course, depending on the individual characteristics of how your body heals). When this happens in a finger, it is so close to the surface that it is very visible. From about 3 months post injury the body is spending less time making new scar tissue, and more time remodelling what is there, making it more organised, flatter and stronger - more like normal healthy pre-injury tissue. This process continues for many months - likely 18-24 moths post-injury - but is very slow and incremental. So, don't give up hope! your body is obviously really good at healing, and made stacks of extra bone around the avulsion fracture site, but it is still working on trying to optimise it, and will be for the next year or so. It will probably never be as slim as it used to be, but it should end up better than it is right now. Cheers
Awesome reply, thanks. I was feeling down, just came from the fracture clinic 2 months post-accident as I only really noticed it was a problem way too late. Consultant told me they can't do anything now! @@iandowley8059
Good question, Steven. I would start by washing and drying the rest of your hand with the splint still on so you don't need to worry about the injured joint bending. Then, take the wet splint off with the finger resting flat on the table - the table becomes your splint. Washing and drying the splint with only one free hand is fiddly and annoying, but possible to manage if there is no-one else around who can do it for you. You can wipe down the fingertip while it is out of the splint if it is dirty, but the most important thing is to get it properly dry before it goes back in the splint. My preference is to lift the fingertip off the table using the other hand (as long as the injured joint is always supported and isn't allowed to bend). This lets the air circulate around the whole fingertip which is great for your skin health. If it needs longer to air out, try supporting the injured fingertip with the thumb of that same hand (like a flattened 'OK' sign). This is a great position for gentle wiping, washing and drying of the fingertip, and for some prolonged airing out if the skin is getting a bit soft and macerated. Hope this helps. Recover well!
Good on you, Tmak. It is certainly possible to treat a mallet finger with a tape-on splint if you are able to look after your skin carefully so it doesn't get irritated or macerated (soggy and damaged). Hope you have an excellent recovery.
When i started hand therapy, the joint had no lag but was very very stiff. The hand therapist started performing very painful passive streches, I started gaining mobility but the lag started increasing. Should I stop these painful exercices to stop lag from increasing? Won't the finger stay stiff if dont do them?
Hi Daniel, in my experience a lag can be permanent, but stiffness usually (not always) resolves with time and gentle, persistent effort. There are very few occasions I have ever needed to push someone's finger through pain to get movement back again - and when I have it was a month after they stopped wearing their splint. Be nice to it! Hope you make a brilliant recovery. - Ian
The fingertip really needs to be in a good position in the splint to maximise the chance of tendon healing and to minimise the risk of permanent lag. Full extension, or very slight hyperextension is good. Too much hyperextension is risky - too much pressure on skin and healing tendon. However, it can be very difficult to get the position right for some patients. Very small or very slim fingers are tricky to splint, and hypermobile fingers (very flexible joints) are the most difficult of all. I hope your finger makes an excellent recovery 🙂
Great simple video. !. Thanks..I'm on week 6 wearing full finger splint from rite aid. I bent the splint slightly upwards .should I wait till week 8...? To take it off...or start excercises now...
@@1commonsense934 Definitely give it a full 8 weeks of full time protection then. Be cautious and gentle after that, also - there is a greater risk of a lag (partial droop) developing. Hope it goes well.
If you went through the whole process and still have a 20 degree or more droop, can you generally get more benefit from splinting for a long period again. Maybe making sure it’s splinted straighter the second time? Thanks!
HI there, sorry to hear of the lag you have developed. There are lots of variables at play here, so no clear cut answer to your question. Trying to guide my patients through this stage of recovery - when a lag has formed - is one of the trickiest parts of my job! Things to keep in mind... having some degree of permanent lag is VERY common, and is basically considered normal. What matters is the degree of the lag, whether it is stable or progressively worsening, and how much it bothers you! Generally, anything less than 15 degrees is well tolerated in the longer term. It isn't too visible, and doesn't get in the way too much. Anything greater than 20 degrees becomes increasingly problematic! If you have a stable lag of less than 15 degrees, I would almost certainly advise against surgery - you are risking a possible worse outcome for very little gain. When there is a more significant lag, I will usually try a further period of full time splinting - maybe 3-4 weeks - to see if the tendon/scar will tighten up a bit. Surgery is usually kept in reserve for cases that just won't improve. This is rare, but it certainly can happen. All the best for your recovery!
No one talks about the pain on top of the mallet finger. I tore my tendon with a piece of bone. The top of the finger is RED and feels like a hot sore sliver. I got to the doctor, X-rays showed bone off. I iced it and man did that hurt it. Since Sept 13,2023. It’s Oct 6th now. I wear my splint every day all day and night. Dr said it’s slightly better…. But my concern is there’s no splint that I can purchase around here to bring the tip up.. like the Dr wants. I created my own. I’m crafty so I made several types. I really want more advice so I guess I need a hand doctor finger doctor… My finger hurts so bad when it gets wet or hot over the stove. 😫
Hi Debra. You are right, these injuries can sometimes be extremely painful - but surprisingly many of them don't hurt at all, even ones with fractures like yours. Well done making your own splints! What sort of materials were you using? Which option did you find was the best? I have seen patients successfully splint a mallet injury just with a simple wooden pop-stick or tongue depressor, held on with tape. It is less convenient than a custom-fitted splint like we use, but it can still do the job. If you can track down a hand therapist in your area that would certainly be the best option, but I know this can be difficult or impossible depending on where you live. I hope you find a good way to help your injury recover very well. All the best
@@iandowley8059Today is Dec 2, 2023: it’s still sore in top. Sore on the side because I use my fork. Dr said NO SPLINT anymore, use it! I do I do, I do too much I think. I go into my splint for only hours at a time thinking it needs the comfort zone. It’s not stiff now. But I need to say, my homemade splints were from Temu. They had to be carved out on the top because it’s too painful to have plastic there. I used the aluminum splint mostly. Yes, I have a 10% lag and Dr said it’s not going to get 100% normal. Yes, the tape was very painful especially over my knuckle folds … omg just awful. My finger turned purple from it. That’s better now! So one Ortho Therapist made a 4mm thick black ugly heavy splint I had to go back the next day and complain about it. She said it’s worked for other patients …. So now I’m in 10 weeks in and it’s troubling. Is doing crafts and scrubbing and housework therapy??
Hello - thanks for reaching out. Definitely worth trying. Treat it as though it was a brand new injury - full time splinting for 6 weeks (if fractured) or 8 weeks (if no fracture). The % chance of a good outcome will certainly be a little lower 2 months after the injury, but I have occasionally had good results even 6 or 12 months post injury. And you can be certain the the chance of a good outcome without splinting is 0% 🙃. Absolutely worth giving it a chance. Here's to a great outcome for you!
@@iandowley8059 Thank you SO much, I am deeply appreciative as I was in the fracture clinic yesterday and was so upset when the consultant told me "there's nothing we can do, it's too late"--and I am only at 7 weeks post accident! You're an angel !
Thanks for your query - the custom-made thermoplastic splint shown in the video is made by a hand therapist. This might be someone who trained as a physiotherapist or occupational therapist, but subsequently specialised in treating the upper limb only. So, your best bet is to try finding a hand therapist in your area. In Australia, hand therapists can be found on the AHTA (Aust Hand Therapy Assoc) website. Perhaps there is a similar resource in your country? If you can't get a custom-fitted splint for your finger, it is definitely possible to treat a mallet finger injury without it. The underlying principles still apply - get the last joint of the finger supported in a fully straight position, and keep it there for 6-8 weeks! I have seen it done successfully just using a wooden tongue depressor and some electrical tape 😊. All the best with getting your mallet finger healed.
hello doc, I'm currently in the recovery period by putting a splint on my finger, but sometimes I let go to clean the splint but suddenly i raise my hand a little so that it creates a bent finger down. Can it cause repeat days for recovery?
Hi there, and thanks for your excellent question. The process of removing and replacing the splint is REALLY important to get right, and yes, if your fingertip bends significantly during the process you should start your 6-8 weeks of full-time splinting all over again. This is especially true in the first couple of weeks after you start, when the scar tissue is at its most fragile. Hopefully you might get away with a little bit of gentle bending from 3 weeks onwards, but better not to take a chance if you can help it. We occasionally have patients who simply can't get the splint back on again without the fingertip bending (often people with very hypermobile finger joints) - for these patients we use a thermoplastic product called Orficast to make a splint that can get wet and simply drip dry, and never needs to be removed. Depending on where you live you may be able to find someone who can try this for you? All the best with your recovery!
Amazing video, subbed! I was wondering doc, I have had my mallet ring finger in a splint for 12 weeks, had it come out at 3 weeks, did 7, came out, did another 4. Now I have a 10 degree lag. I splinted with a pharmacy foam and aluminum splint but i think it wasn't hyperextended. Does the hyperextension help overcorrect for the lag? If I keep a better splint on for more time, could I improve the lag? How long would I need to splint it again for? What about a pin?
Hello! Glad you found the vid helpful 🙂. Your finger has had a rather unusual pathway of on/off splinting, but even though it has been a bit disrupted, 12 weeks of total splinting should be enough for the tendon to be really well healed. A 10 degree lag at this stage is just an indication that the tendon has healed in a slightly longer position than it was in before the injury. Further splinting allow this healed/scarred tendon to tighten up a little shorter, but I would look at the risk/benefit analysis and suggest that you are taking more risk (of stiffness and disuse) for a slight chance of gaining a few degrees, which will have zero functional benefit. As long as the lag stays at 10-15 deg, it is usually a non-issue in the longer term. I would encourage you to stop splinting, get the finger back into functional activities again, and only splint/protect it during high risk sporting activities. Hope this helps! Here's to a fantastic result for you and your finger...
Thanks Doc those are really helpful points! In your experience, does the hyperextended splint have a better prognosis for eventual lag than the standard splints? I'm a guitar player and although my right ring is fortunately one of my least important fingers, I still really hope to regain the ability to play with it. Glad there are people out there who put in the work to help people with nagging injuries like these, thanks!@@iandowley8059
I kept my splint on the tendon mallet finger for 3 months but it now has a lag. I haven’t worn the splint for a few weeks now, apart from night times. Should i start wearing it again full time to get rid of this lag, or is it too late?
Hi there. A persistent lag is very common, especially when the injury was to the tendon rather than the bone. Often we are trying to minimise the degree of lag, rather than get rid of it altogether. If you have been splint free during the day for several weeks and the lag has not been getting any worse then it is probably pretty much 'set' - the tendon has simply healed in a more elongated form than it used to have. If the degree of lag is a major concern (eg if your fingertip gets in the way, catches on things all the time) then you could try a couple of weeks of full time splinting to see if the scar tissue will contract a little further? If it is not bothering you, then just get used to the new you! Regards, - Ian
Yeah bro I have a lag too. I wore the splint for 8 weeks then 2 weeks at night and now it’s been off for two weeks and I can make a fist but can’t fully bend that finger down however motion is there probably because it’s stiff… is urs fully working and functional?
@@swid-it880 So I decided to wear my splint for another week after it seemed so laggy, and really gently stretch it after occasionally. I had it on much longer than they suggested. It’s almost perfect now, hardly lagging at all. It was stiff, But the flexibility has improved since 3 months ago. Put splint on again for a while and see how it goes
I was wondering@@fodrocksuk.forestofdeanroc5686 what splint were you using to improv the lag? I'm in the same position. Was it a hyperextended one or a custom one? I wasn't able to get anything better than a pharmacy aluminum and foam splint- the specialist I went to gave me a stax and it was less stable and irritating. What did you use to get an improvement?
Very likely, as long as you are very diligent at keeping the splint on full time so the end joint never has a chance to bend. There is some increase in risk from delayed splinting, but this should be minimal after 18 days. I have successfully treated patients several months after the initial injury. I hope your finger makes a complete recovery!
Thank you for posting your video. The information you posted and how you presented was greatly reassuring to help me with this healing process.
Glad you found it helpful!
Phenomenal and comprehensive guide to mallet finger. Thank you for releasing this information!
Cheers, Greg. Glad you found it useful. - Ian
Thank you. This is very helpful.
great video, thank you.
I did a ligamentous mallet to my right pinky, then 2 weeks laters a ligamentous mallet to my left middle finger. I'm 1 week away from splint removal but the local hand therapists are completely booked out. Thanks for the advice on stiffness exercises.
Wow, Darryl, you don't do things by halves - must have been a challenge to have a splint on each hand! Hope your recovery is really smooth.
Your video and the questions and answers are very helpful indeed. I had to wait 6 weeks before I saw the doctor after catching my finger in the car door. He diagnosed it as a mallet finger that was too late to splint. Once I knew what the injury was I was in a position to check out possible solutions. I now have a custom splint applied and into my 2nd. week. I’m hopeful that after the recommendation of keeping it on for 8 weeks that it will be on the mend. With the additional information gleaned from your video I am in a better position to see the treatment through to the end. Thanks. Selina
Hi Selina, good to hear you are getting the right treatment now. Definitely not too late at 6 weeks - I have even seen good results occasionally when there have been a few months of no treatment, though the odds of a good outcome certainly decrease. Here's to an excellent recovery for your finger! Cheers
Good to hear that, Ian.
Just got my dorsal splint off today after 9 weeks and they moved me to a stack splint for heavy lifting and sleeping. This video was really informative and positive. Thanks!
How is your finger..I'm on week 6..how do I know how long to keep splint on....is it better to go longer or to take off splint and see... I dont want to disrupt my healing process..
Thank you!
👍😊
Hi Ian, thank you so much for the information. Is splinting at all possible 5 years after injury?
Hello Sasha, that's a really tricky one... I don't know of any research or evidence looking into it, and my own experience only extends to mallet fingers up to 12-18 months post injury. What I have found is that the rate of successful outcomes seems consistently high for several months post-injury, then starts to decrease. I have occasionally had good outcomes with patients whose injury was >12 months before, but far from guaranteed. I suspect that after 5 years the injured tendon (or bone) has essentially stopped trying to heal, and has 'settled in' to its new normal. There is not much reason not to give it a go (it will be a bit annoying for 6-8 weeks, but nothing worse than that), but I do not feel very hopeful. If you try it and prove me wrong, please let me know! All the best, - Ian
Great informative video. AAfter 8 weeks of splinting and 2 weeks of hand exercises, the initial finger was straight but has slowly drooped to around 20 degrees. After all this time, is it worthwhile to re-splint?.
Not as long as it's functional. If you ask why, you may gain not the same functionality after another surgery. The small bending is normal as your finger won't ever be the same as before. 20degrees is still fine with functionality.
Really informative video. Thank you!
You say that a lag can start to appear after removing the splint when you start moving your finger, as a result of doing too much too soon. I believe this is due to the tendon stretching.
Is this still possible if you had a bony mallet finger instead? Or is there a much lower chance of a lag appearing due to exercises?
I'm in my exercises phase now and am wary of doing too much.
Hi Sam, glad you found the video helpful. You are right, the lag is due to the healed tendon ending up longer than it was before the injury. This may be due to poor positioning of the fingertip in the splint, or from the tendon 'stretching' a bit during the exercise/rehab phase, but it can sometimes happen anyway, even when the patient has been super careful and done everything right. It is definitely more common when there is a tendon injury with no fracture involved, but bone healing isn't always perfect either, and we sometimes see a lag after a bony injury.
It is sensible to be cautious during this phase of splint weaning while you get the fingertip moving. I hope your finger makes a fabulous recovery!
Cheers
- Ian
@@iandowley8059 Thank you! Really appreciate you taking the time to answer!
Thank you for the clear video! I have injured my left pinky finger in December due to a volleyball accident. The physician diagnosed it with an X-ray to be a bony mallet finger and fixed it into a slight hyperflexion position with a splint. I wore it for a little more than 6 weeks and after finally being allowed to take it off, have a little splint for night and activities, started exercises. Now 8 months later there is still a drooping of 12%, by the hand therapist said as normal, but also a big bump has formed on top of the DIP joint that is preventing me to fully bend the pinky and it also looks not very pretty. I can't find any information about the bump, is this scar tissue, a bony bump, fluid buildup, will this disappear after more months? Will splinting it again help? The drooping does not bother me very much, but the bump is so frustrating and ugly! If anyone can let me know if something can be done about the bump, would be very appreciated!
Hi Dorien, what you describe is really common after almost any kind of finger injury. The way the body heals is always a bit of an over-reaction in the early stages - throwing together a heap of collagen fibers (in the case of ligament or tendon injury) or new bone tissue (in the case of a fracture) with the focus on speed rather than neatness. Some bulkiness and thickening at the repair site is basically normal (varying from person to person, of course, depending on the individual characteristics of how your body heals). When this happens in a finger, it is so close to the surface that it is very visible.
From about 3 months post injury the body is spending less time making new scar tissue, and more time remodelling what is there, making it more organised, flatter and stronger - more like normal healthy pre-injury tissue. This process continues for many months - likely 18-24 moths post-injury - but is very slow and incremental. So, don't give up hope! your body is obviously really good at healing, and made stacks of extra bone around the avulsion fracture site, but it is still working on trying to optimise it, and will be for the next year or so. It will probably never be as slim as it used to be, but it should end up better than it is right now.
Cheers
Awesome reply, thanks. I was feeling down, just came from the fracture clinic 2 months post-accident as I only really noticed it was a problem way too late. Consultant told me they can't do anything now! @@iandowley8059
can a mallet finger get fixed with a splint after 1 month of doing nothing about since I got it???
Ok so U explain washing and drying before putting splint back on. Can u explain how u can wash/dry your hands without bending your finger please
Good question, Steven. I would start by washing and drying the rest of your hand with the splint still on so you don't need to worry about the injured joint bending. Then, take the wet splint off with the finger resting flat on the table - the table becomes your splint. Washing and drying the splint with only one free hand is fiddly and annoying, but possible to manage if there is no-one else around who can do it for you. You can wipe down the fingertip while it is out of the splint if it is dirty, but the most important thing is to get it properly dry before it goes back in the splint. My preference is to lift the fingertip off the table using the other hand (as long as the injured joint is always supported and isn't allowed to bend). This lets the air circulate around the whole fingertip which is great for your skin health. If it needs longer to air out, try supporting the injured fingertip with the thumb of that same hand (like a flattened 'OK' sign). This is a great position for gentle wiping, washing and drying of the fingertip, and for some prolonged airing out if the skin is getting a bit soft and macerated.
Hope this helps. Recover well!
Can a lag be reduced after over a year?
when i got xrays the ER nurse gave me a regular aluminum splint which i strategically bent for mallet finger healing
Good on you, Tmak. It is certainly possible to treat a mallet finger with a tape-on splint if you are able to look after your skin carefully so it doesn't get irritated or macerated (soggy and damaged). Hope you have an excellent recovery.
I got mallet finger 2 years ago and still hasn't healed and they said i dont need surgery... any suggestion?
When i started hand therapy, the joint had no lag but was very very stiff. The hand therapist started performing very painful passive streches, I started gaining mobility but the lag started increasing. Should I stop these painful exercices to stop lag from increasing? Won't the finger stay stiff if dont do them?
Hi Daniel, in my experience a lag can be permanent, but stiffness usually (not always) resolves with time and gentle, persistent effort. There are very few occasions I have ever needed to push someone's finger through pain to get movement back again - and when I have it was a month after they stopped wearing their splint. Be nice to it! Hope you make a brilliant recovery. - Ian
I had my injury 5 years ago. Is it too late to try and use splint to heal it?
I have the same question🥲
Why nurse doesn't put my finger in a position like this? It has some lag while it is in a custom splint he made.
The fingertip really needs to be in a good position in the splint to maximise the chance of tendon healing and to minimise the risk of permanent lag. Full extension, or very slight hyperextension is good. Too much hyperextension is risky - too much pressure on skin and healing tendon.
However, it can be very difficult to get the position right for some patients. Very small or very slim fingers are tricky to splint, and hypermobile fingers (very flexible joints) are the most difficult of all.
I hope your finger makes an excellent recovery 🙂
Great simple video. !. Thanks..I'm on week 6 wearing full finger splint from rite aid. I bent the splint slightly upwards .should I wait till week 8...? To take it off...or start excercises now...
Hi Stephen. All depends on whether there is a fracture or not. If no Xray done, err on the side of caution and wait for the 8 week point... good luck!
@@iandowley8059 thank you..I had xray..no bone broken..assume tendon stretched or torn..
@@1commonsense934 Definitely give it a full 8 weeks of full time protection then. Be cautious and gentle after that, also - there is a greater risk of a lag (partial droop) developing. Hope it goes well.
@@iandowley8059 thanks for your help
If you went through the whole process and still have a 20 degree or more droop, can you generally get more benefit from splinting for a long period again. Maybe making sure it’s splinted straighter the second time? Thanks!
I have a lag on my tendon mallet finger. Do I need a revision surgery or if I keep it in a split for eight weeks will the tendon tighten up?
HI there, sorry to hear of the lag you have developed. There are lots of variables at play here, so no clear cut answer to your question. Trying to guide my patients through this stage of recovery - when a lag has formed - is one of the trickiest parts of my job! Things to keep in mind... having some degree of permanent lag is VERY common, and is basically considered normal. What matters is the degree of the lag, whether it is stable or progressively worsening, and how much it bothers you! Generally, anything less than 15 degrees is well tolerated in the longer term. It isn't too visible, and doesn't get in the way too much. Anything greater than 20 degrees becomes increasingly problematic! If you have a stable lag of less than 15 degrees, I would almost certainly advise against surgery - you are risking a possible worse outcome for very little gain. When there is a more significant lag, I will usually try a further period of full time splinting - maybe 3-4 weeks - to see if the tendon/scar will tighten up a bit. Surgery is usually kept in reserve for cases that just won't improve. This is rare, but it certainly can happen.
All the best for your recovery!
How much time does it take to heal after wearing splint for 8 weeks to become my finger to normal functioning
Any update
No one talks about the pain on top of the mallet finger. I tore my tendon with a piece of bone. The top of the finger is RED and feels like a hot sore sliver. I got to the doctor, X-rays showed bone off. I iced it and man did that hurt it. Since Sept 13,2023. It’s Oct 6th now. I wear my splint every day all day and night. Dr said it’s slightly better…. But my concern is there’s no splint that I can purchase around here to bring the tip up.. like the Dr wants. I created my own. I’m crafty so I made several types. I really want more advice so I guess I need a hand doctor finger doctor…
My finger hurts so bad when it gets wet or hot over the stove.
😫
Hi Debra. You are right, these injuries can sometimes be extremely painful - but surprisingly many of them don't hurt at all, even ones with fractures like yours. Well done making your own splints! What sort of materials were you using? Which option did you find was the best? I have seen patients successfully splint a mallet injury just with a simple wooden pop-stick or tongue depressor, held on with tape. It is less convenient than a custom-fitted splint like we use, but it can still do the job.
If you can track down a hand therapist in your area that would certainly be the best option, but I know this can be difficult or impossible depending on where you live. I hope you find a good way to help your injury recover very well. All the best
I feel you bro i broke mine on september 3rd, now it looks and feels like shit
😞So sorry to hear it@@TerrorOnRUclips. I hope it improves heaps in the coming weeks.
@@iandowley8059Today is Dec 2, 2023: it’s still sore in top. Sore on the side because I use my fork. Dr said NO SPLINT anymore, use it! I do I do, I do too much I think. I go into my splint for only hours at a time thinking it needs the comfort zone. It’s not stiff now. But I need to say, my homemade splints were from Temu. They had to be carved out on the top because it’s too painful to have plastic there. I used the aluminum splint mostly. Yes, I have a 10% lag and Dr said it’s not going to get 100% normal. Yes, the tape was very painful especially over my knuckle folds … omg just awful. My finger turned purple from it. That’s better now! So one Ortho Therapist made a 4mm thick black ugly heavy splint I had to go back the next day and complain about it. She said it’s worked for other patients …. So now I’m in 10 weeks in and it’s troubling. Is doing crafts and scrubbing and housework therapy??
Is there any point in using a splint on a 2 month old mallet finger injury? Thank you.
Hello - thanks for reaching out. Definitely worth trying. Treat it as though it was a brand new injury - full time splinting for 6 weeks (if fractured) or 8 weeks (if no fracture). The % chance of a good outcome will certainly be a little lower 2 months after the injury, but I have occasionally had good results even 6 or 12 months post injury. And you can be certain the the chance of a good outcome without splinting is 0% 🙃. Absolutely worth giving it a chance. Here's to a great outcome for you!
@@iandowley8059 Thank you SO much, I am deeply appreciative as I was in the fracture clinic yesterday and was so upset when the consultant told me "there's nothing we can do, it's too late"--and I am only at 7 weeks post accident! You're an angel !
@@merrymeditation any update
How do I purchase that splint?
Thanks for your query - the custom-made thermoplastic splint shown in the video is made by a hand therapist. This might be someone who trained as a physiotherapist or occupational therapist, but subsequently specialised in treating the upper limb only. So, your best bet is to try finding a hand therapist in your area. In Australia, hand therapists can be found on the AHTA (Aust Hand Therapy Assoc) website. Perhaps there is a similar resource in your country? If you can't get a custom-fitted splint for your finger, it is definitely possible to treat a mallet finger injury without it. The underlying principles still apply - get the last joint of the finger supported in a fully straight position, and keep it there for 6-8 weeks! I have seen it done successfully just using a wooden tongue depressor and some electrical tape 😊. All the best with getting your mallet finger healed.
hello doc, I'm currently in the recovery period by putting a splint on my finger, but sometimes I let go to clean the splint but suddenly i raise my hand a little so that it creates a bent finger down. Can it cause repeat days for recovery?
Hi there, and thanks for your excellent question. The process of removing and replacing the splint is REALLY important to get right, and yes, if your fingertip bends significantly during the process you should start your 6-8 weeks of full-time splinting all over again. This is especially true in the first couple of weeks after you start, when the scar tissue is at its most fragile. Hopefully you might get away with a little bit of gentle bending from 3 weeks onwards, but better not to take a chance if you can help it. We occasionally have patients who simply can't get the splint back on again without the fingertip bending (often people with very hypermobile finger joints) - for these patients we use a thermoplastic product called Orficast to make a splint that can get wet and simply drip dry, and never needs to be removed. Depending on where you live you may be able to find someone who can try this for you?
All the best with your recovery!
@@iandowley8059I need one NOW… where do I get one????
Amazing video, subbed! I was wondering doc, I have had my mallet ring finger in a splint for 12 weeks, had it come out at 3 weeks, did 7, came out, did another 4. Now I have a 10 degree lag. I splinted with a pharmacy foam and aluminum splint but i think it wasn't hyperextended. Does the hyperextension help overcorrect for the lag? If I keep a better splint on for more time, could I improve the lag? How long would I need to splint it again for? What about a pin?
Hello! Glad you found the vid helpful 🙂. Your finger has had a rather unusual pathway of on/off splinting, but even though it has been a bit disrupted, 12 weeks of total splinting should be enough for the tendon to be really well healed. A 10 degree lag at this stage is just an indication that the tendon has healed in a slightly longer position than it was in before the injury. Further splinting allow this healed/scarred tendon to tighten up a little shorter, but I would look at the risk/benefit analysis and suggest that you are taking more risk (of stiffness and disuse) for a slight chance of gaining a few degrees, which will have zero functional benefit. As long as the lag stays at 10-15 deg, it is usually a non-issue in the longer term. I would encourage you to stop splinting, get the finger back into functional activities again, and only splint/protect it during high risk sporting activities.
Hope this helps! Here's to a fantastic result for you and your finger...
Thanks Doc those are really helpful points! In your experience, does the hyperextended splint have a better prognosis for eventual lag than the standard splints? I'm a guitar player and although my right ring is fortunately one of my least important fingers, I still really hope to regain the ability to play with it. Glad there are people out there who put in the work to help people with nagging injuries like these, thanks!@@iandowley8059
I kept my splint on the tendon mallet finger for 3 months but it now has a lag.
I haven’t worn the splint for a few weeks now, apart from night times. Should i start wearing it again full time to get rid of this lag, or is it too late?
Hi there. A persistent lag is very common, especially when the injury was to the tendon rather than the bone. Often we are trying to minimise the degree of lag, rather than get rid of it altogether. If you have been splint free during the day for several weeks and the lag has not been getting any worse then it is probably pretty much 'set' - the tendon has simply healed in a more elongated form than it used to have. If the degree of lag is a major concern (eg if your fingertip gets in the way, catches on things all the time) then you could try a couple of weeks of full time splinting to see if the scar tissue will contract a little further? If it is not bothering you, then just get used to the new you!
Regards, - Ian
@@iandowley8059 thank you, that’s kind of you to reply.
Yeah bro I have a lag too. I wore the splint for 8 weeks then 2 weeks at night and now it’s been off for two weeks and I can make a fist but can’t fully bend that finger down however motion is there probably because it’s stiff… is urs fully working and functional?
@@swid-it880 So I decided to wear my splint for another week after it seemed so laggy, and really gently stretch it after occasionally. I had it on much longer than they suggested. It’s almost perfect now, hardly lagging at all. It was stiff, But the flexibility has improved since 3 months ago. Put splint on again for a while and see how it goes
I was wondering@@fodrocksuk.forestofdeanroc5686 what splint were you using to improv the lag? I'm in the same position. Was it a hyperextended one or a custom one? I wasn't able to get anything better than a pharmacy aluminum and foam splint- the specialist I went to gave me a stax and it was less stable and irritating. What did you use to get an improvement?
Dear sir I used splint after 18 days will it recover?
Very likely, as long as you are very diligent at keeping the splint on full time so the end joint never has a chance to bend. There is some increase in risk from delayed splinting, but this should be minimal after 18 days. I have successfully treated patients several months after the initial injury. I hope your finger makes a complete recovery!