Mallet fracture

Case contributed by Elton John Dullas Decena
Diagnosis almost certain

Presentation

Chief complaint: right middle finger trauma due to basketball last night. Swelling noted.

Patient Data

Age: 17 years
Gender: Male
x-ray

XR finger 3rd digit right

Technique:
Frontal, lateral and oblique radiographs of the right third digit.
Examination is performed for the evaluation of trauma to the right middle finger

Findings:
Focal avulsion fragment is identified involving the dorsal surface of the distal phalanx of the third digit.  The avulsion fragment is close to the apposing joint surface. Rest of the visualized bones appear unremarkable.
Mild soft tissue swelling is identified adjacent to the fracture.

Conclusion:
Radiographic features are consistent with avulsion fracture of the dorsal surface of the distal phalanx at its articulating edge.

Case Discussion

In a mallet injury, when an object hits the tip of the finger or thumb, the force of the blow tears the extensor tendon. 

The injury may rupture the tendon or pull the tendon away from its attachment to the distal phalanx. In some cases, this is accompanied by an avulsion injury.

Most mallet finger injuries are treated with splinting. A splint holds the fingertip in extension until it heals.

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