. Upper Limb Injuries | Advanced Hand, Wrist & Nerve Centre

Upper Limb Injuries – Mallet Finger, Tendon & Nerve

Mallet Finger or Thumb

Mallet finger or thumb is a deformity that occurs at the tip of the finger or thumb, resulting in the inability to straighten the finger or thumb completely. This happens when an object strikes the tip of the finger or when the fingertip undergoes forceful bending. As a result, the tendon that helps to straighten the finger, is torn. In some severe cases, the force of the blow may even cause a fracture in the finger, and this is known as an avulsion fracture.

Upper Limb Injuries


Mallet finger is a common injury after trauma to the tip of the finger or when forceful bending occurs. Although a hard blow to the tendon is the cause of most mallet finger injuries, such as closing the door against your finger, a minor force such as performing simple tasks can sometimes also injure the tendon.


Signs And Symptoms

Patients suffering from mallet finger will see the affected fingertip drooping. The fingertip may feel painful, swollen or bruised. In some cases, the blood collects beneath the nail, causing the nail to become detached from the skin fold.



In addition to performing a clinical examination, your hand specialist may also order an x-ray to determine the presence of an avulsion fracture.



Most mallet finger injuries can be treated without surgery. Hand surgeons will prescribe continuous splinting of the fingertip for at least six weeks. This is to maintain the joint in a straight position until the tendon heals. Patients will have to wear the splint at all times before starting gentle active range of motion exercises with interval splinting for two more weeks. Your hand surgeon will instruct you on how to change the splint and prevent the bending of the finger while doing so.


Surgery is recommended for complex cases of mallet finger.


Tendon And Nerve Injuries

Tendons are tissues that control movements in your fingers, hand and wrist. They are located over the flexor (palmar) and extensor (dorsal) surfaces of the upper limb. Sustaining a deep cut over the surface of your fingers, hand, wrist, or even forearm can cause damage to your flexor or extensor tendons. Such injuries can make it difficult for you to ben or straighten your fingers, hand or wrist.


As the nerves and vessels of the upper limb are sometimes located very close to the tendons, a deep cut may also cause concomitant injuries to the nerves and blood vessels, resulting in numbness, possibly weakness and even reduced blood supply to the hand.


Signs And Symptoms

The most common signs and symptoms of tendon and nerve injuries include:

  • The inability to bend one or more joints of your upper limb
  • Pain upon bending the injured part
  • Numbness in the distribution of the affected nerve
  • Weakness of the muscles supplied by the affected nerve



During the consultation with your hand surgeon, you may be asked to bend and straighten your fingers, hand and wrist. Occasionally, he or she may test your hand strength by asking you to bend your injured finger as they hold the other fingers down. One should also check for any injured nerves or blood vessels. X-rays are also performed to determine if there are any associated bony injuries.



Because tendons cannot heal on their own unless the ends are touching, most cases of completely severed tendon would require surgery to recover. However, if your tendons are only partially torn then splinting may be recommended by your hand surgeon.


Every case is different, hence it is best to consult a hand surgeon to determine the treatment method that is most suitable for you. Reach out to us today if you have a mallet finger or are suffering from any tendon and nerve injuries, and let us help you.

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