Mallet Finger
Mallet finger is an injury to the tendon that straightens the tip of a finger or thumb, leaving the fingertip drooping. Midwest Orthopaedics at Rush’s fellowship-trained hand surgeons diagnose mallet finger and treat it, most often with a splint and sometimes with surgery.
Mallet finger, also called baseball finger, often looks like a minor jammed fingertip, which makes it easy to put off. The American Academy of Orthopaedic Surgeons (AAOS) notes that most mallet finger injuries can be treated without surgery when splinting starts promptly, and that improper treatment can leave the fingertip stiff or deformed. The hand and wrist specialists at Midwest Orthopaedics at Rush evaluate the injury, fit the splint and follow the finger through healing. The orthopedic program at Rush, anchored by Midwest Orthopaedics at Rush, is ranked No. 9 in the nation in the 2026–2027 U.S. News & World Report Best Hospitals rankings.
What Mallet Finger Is
The end joint of each finger, the distal interphalangeal (DIP) joint, is straightened by a thin extensor tendon on the back of the finger. In a mallet finger, that tendon tears or pulls away from the bone it attaches to, so the joint can still bend but can no longer straighten on its own. The thumb can be injured the same way at its end joint.
The usual cause is a hard object, such as a ball, striking the tip of the finger and forcing it to bend further than it should. AAOS notes that a minor force, such as tucking in a bed sheet, can sometimes be enough. The long, ring and small fingers of the dominant hand are injured most often.
Sometimes the tendon pulls off a small piece of bone where it attaches. This is often called a bony mallet finger, and it is one of the finger fractures a hand surgeon checks for on X-ray.
Symptoms of Mallet Finger
According to AAOS, the signs of a mallet finger include:
- A fingertip that droops and will not straighten on its own
- A fingertip that straightens only when you push it up with the other hand
- Pain, swelling and bruising at the end joint
Because it starts like many other finger injuries, a mallet finger is easy to mistake for a sprain. If you are trying to decide whether a sore finger is jammed or broken, a fingertip that will not straighten is a reason to have it examined.
Blood under the nail, or a nail that has come loose, needs immediate attention. AAOS notes that it can signal a cut in the nail bed or an open fracture with a risk of infection.
When to See a Hand Specialist
AAOS recommends seeing a hand surgeon as soon as possible, ideally within a week of the injury. In the meantime, ice and keeping the hand raised above the level of the heart can help with swelling, and a padded splint that holds the fingertip straight, without blocking the other joints, may be used. AAOS also notes that in some cases, treatment delayed by as long as a month still led to complete healing, so a mallet finger noticed late is still worth having evaluated.
How a Hand Specialist Diagnoses Mallet Finger
The exam centers on one question: can you straighten the fingertip without help? X-rays, available through the practice’s orthopedic imaging services, show whether a piece of bone has pulled away with the tendon, how large it is, and whether the end joint has slipped out of alignment. Those findings largely decide between splinting and surgery.
Treatment for Mallet Finger
Most mallet finger injuries are treated without surgery. The goal is to hold the end joint straight, without interruption, long enough for the tendon or bone to heal in place.
Splinting
A splint holds the fingertip straight while leaving the middle knuckle free to bend. Many are custom-made by hand therapists, and Midwest Orthopaedics at Rush’s occupational therapists make custom splints and show patients how to care for them.
- Full-time wear: AAOS describes wearing the splint full time for 6 to 8 weeks.
- Keep the tip straight at all times: if the fingertip droops at any point, healing is disrupted and splinting must be extended. The splint should come off for washing only if the tip is held straight with the other hand the whole time it is off.
- Weaning: after the full-time period, the splint is worn less often, perhaps only at night, for another 3 to 4 weeks.
- Skin checks: the splint can irritate the skin, so your care team may show you how to check your skin and may schedule follow-up visits.
When surgery is considered
Surgery is uncommon for a mallet finger with no fracture and a well-aligned joint. The tendon is thin, which makes stitching it back together difficult. Surgery may be considered when:
- A large piece of bone has pulled away with the tendon
- The end joint has slipped out of alignment
- A splint cannot be worn reliably for the full treatment period
Surgery typically uses pins to hold the bone fragment and realign the joint. A pin placed across the joint can also act as an internal splint, though it adds the risks of surgery. For a mallet finger that is months or years old, fusing the end joint in a fairly straight position is one option a hand surgeon may discuss.
Recovery and What to Expect
AAOS notes that most patients with mallet finger have a good outcome when the injury is treated promptly and properly. Splinting usually gives acceptable function and appearance, although many people do not regain full straightening of the fingertip, and a slight droop can remain.
Once full-time splinting ends, gentle bending exercises are added gradually as your surgeon or hand therapist directs. If the tip starts to droop again when the splint is off, contact your care team, because a further period of full-time splinting may be needed.
Left untreated, a mallet finger can stay bent, and in the worst cases it can lead to a swan-neck deformity and reduced finger function.
Mallet Finger in Children
In children, the same injury can involve the growth plate, an area of cartilage near the end of the bone. AAOS notes that a doctor needs to evaluate and treat these injuries carefully so the finger does not grow stunted or deformed. MOR’s pediatric orthopedics team treats growth plate fractures in children and adolescents alongside the hand surgeons.
Meet the Hand Team
Every hand and wrist physician at Midwest Orthopaedics at Rush has completed a dedicated hand surgery fellowship after orthopedic residency. The hand team treats mallet finger and other finger tendon injuries from splinting through surgical repair, working alongside the practice’s occupational therapists through recovery.
Frequently Asked Questions
Will a mallet finger heal on its own?
Usually not without treatment. If the end joint is not held straight while the tendon heals, the fingertip is likely to stay bent. A splint worn exactly as directed gives the tendon the chance to heal in place.
How long do you wear a splint for mallet finger?
AAOS describes full-time splinting for 6 to 8 weeks, followed by part-time wear, perhaps only at night, for another 3 to 4 weeks. Your hand surgeon sets the schedule based on the injury and how it is healing.
What if my fingertip bends while the splint is off?
Tell your care team. A single bend can disrupt healing, and the usual response is to extend the full-time splinting period.
Does mallet finger need surgery?
Most do not. Surgery is generally considered when a large piece of bone has pulled away, when the end joint has slipped out of alignment, or when a splint cannot be worn for the full treatment period.
Do I need a referral to see a hand surgeon?
No referral is needed to schedule with Midwest Orthopaedics at Rush. Check with your insurance plan if a referral affects your coverage.
Requesting an Appointment
You can request an appointment online, or view the full list of MOR office locations to find the one most convenient for you.
This page describes services offered by Midwest Orthopaedics at Rush and is not medical advice. A drooping fingertip has more than one possible cause, and only an in-person evaluation and X-ray can determine which one applies to you. Please consult a physician about your own injury.