Jammed fingers are a very common complaint in the emergency department, and while often sent home as soon as we verify they don’t have a fracture, there is another more serious complication that needs to be on our radar. Mallet finger, or baseball finger, is often caused by a sudden force that causes hyperflexion in the distal phalanx, and can rupture the extensor tendon. Swelling in the distal phalanx can often mask this injury, which is why it’s very important to assess the patient’s ability to extend the distal phalanx before disposition as this injury is likely to be missed on xray. Identified tendon ruptures need to be splinted in extension for 6-8 weeks with follow up either with a hand specialist or the patient’s PCP. Be careful, because missing this diagnosis can lead to permanent disability!
Swadron, S., and Emily Rose. “Pediatry Fingertip Injuries. EMRap. 2016 June. https://www.emrap.org/episode/shockasthmaand/pediatric
