Question:Could you solve a dispute for me? Our family has a big baseball tradition. Almost everyone has a finger, hand, or elbow injury of some sort. Our 12-year old daughter just got a mallet injury in a game. My husband says leave it alone, and it will heal on its own. But she also plays the violin and piano. Shouldn't this type of injury be treated to save finger motion and function?
Answer:Mallet injuries are so common in baseball, they are also referred to as baseball finger. The athlete reaches out to catch a ball with the fingers extended. The ball hits the tip of the finger and forces it into flexion.
The extensor tendon is torn, leaving the athlete unable to fully extend the finger. The loss of this motion is called an extensor lag. Sometimes there's a small piece of bone still attached to the tendon where it pulled away. This is called an avulsion fracture.
If your daughter can passively straighten her finger all the way, then she may only need a splint during the healing phase. Nonoperative treatment involves placing the finger in a position of full extension and holding it there for six to eight weeks. She shouldn't take the splint off at all (even to play her instruments) during this time.
Failure to adhere to the splint-wearing schedule may result in a prolonged period of time in the splint. As much as six more weeks may be needed before healing is complete. When she can actively straighten the finger all the way, then the splint only has to be worn at night and during sports play or practice.
Protecting the finger from further injury is important. Playing a musical instrument requires good fine motor control. Full flexion and extension of the fingers is essential. If, six months after the injury, the finger still isn't able to bend and straighten completely, then surgery may be needed.Deepak Patel, MD, and Christopher B. Ranney, MD. Managing Hand and Finger Injuries in Ball Sports. In The Journal of Musculoskeletal Medicine. April 2008. Vol. 25. No. 4. Pp. 198-204.
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