When is tendon repair surgery recommended for mallet finger?

Mallet finger happens when the extensor tendon at the fingertip is injured, causing the end joint to droop and making active straightening difficult. An examination checks the tendon, skin, joint position and whether you can actively extend the fingertip. An X-ray may be needed to identify a small bone fragment or a joint that is partly or fully displaced.

Many injuries are initially managed with continuous splinting that keeps the fingertip straight while the tendon heals. Surgery is more likely to enter the discussion when the joint cannot be held in good alignment, a larger fracture affects the joint surface, the injury is open, or suitable splinting has not controlled the problem. The exact plan depends on the injury pattern.

Keep the fingertip supported in the position advised and arrange assessment rather than repeatedly testing whether it straightens. Keep the splint and skin clean as instructed, while maintaining the fingertip straight during changes. Ask how long support is needed and what happens if the finger bends during healing. More information is available about [Tendon Repair Surgery](/treatments/reconstructive-orthopedic-surgery/tendon-repair-surgery/).

Seek prompt care for an open wound, increasing redness or discharge, severe swelling, worsening pain, numbness, or a fingertip that becomes pale, blue or cold. Contact the treating team if the splint causes skin breakdown or cannot keep the fingertip straight.

Ask whether the tendon alone is injured or whether a fracture and joint displacement are present. Discuss splinting technique, skin checks, the reason surgery is or is not advised, expected stiffness, hand therapy and how to protect the repair.