# Mallet finger - Category: chronic - Review status: reviewed (every claim checked against a document named on this page) - Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD71.03 - condition scope only, no dose · Mallet Finger Injuries - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK459373/ · No dose - referral pathway, no medicine given in primary care - Verified date: 2026-08 ## Verified against - No dose - referral pathway, no medicine given in primary care ## Treatment metadata - No drug therapy in primary care (Referral & Advice) ## Complete treatment card ```text MALLET FINGER Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD71.03 - condition scope only, no dose · Mallet Finger Injuries - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK459373/ · No dose - referral pathway, no medicine given in primary care Review status: REVIEWED against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (2) - A direct blow to the fingertip that forces it into flexion is the typical injury described - Pain and a visible deformity at the last finger joint are reported after the injury [visible deformity] SIGNS - what you find (4) - The fingertip rests bent 30 to 45 degrees at the last joint and cannot be actively straightened - The patient cannot actively extend the fingertip at the DIP joint - Swelling and tenderness over the back of the last joint is typical in acute injury but may be minimal later - In chronic cases tenderness may be minimal, but a persistent extensor lag remains evident TESTS (4) - A 3-view x-ray series (front, oblique, and true lateral) is recommended to assess the joint - Plain films are usually normal in tendinous mallet finger because no bone avulsion is present - A bony mallet fracture shows an avulsion fragment at the dorsal base of the fingertip bone - Volar subluxation of the fingertip bone on the true lateral x-ray can signal joint instability and change treatment IF NOT THIS - what else fits (6) - Osteoarthritis - Phalangeal fractures, acute or malunited - Seymour fracture - Swan neck deformity - Metacarpophalangeal joint injuries - An open wound over the extensor tendon near the last knuckle is also on the differential Source StatPearls "Mallet Finger Injuries" - disease-level clinical article Status traced to the source above 1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE) [1st line] Adult Extensor tendon injury at the fingertip joint, usually from a direct blow (e.g. a ball hitting an outstretched finger), causing a droopy fingertip; treated with a continuous extension splint, with referral if there is a large bony fragment or the joint is subluxed. - Refer, with advice Peds Children follow the same pathway: recognise and refer. No primary-care medicine is implied. Source No dose - referral pathway, no medicine given in primary care Why Extensor tendon injury at the fingertip joint, usually from a direct blow (e.g. a ball hitting an outstretched finger), causing a droopy fingertip; treated with a continuous extension splint, with referral if there is a large bony fragment or the joint is subluxed. Caution Large bony avulsion fragment on imaging, joint subluxation, or failed conservative splinting — these need surgical referral. No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to. Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)