A mallet finger injury occurs when the extensor tendon is damaged at the distal interphalangeal (DIP) joint, causing the fingertip to droop. Successful treatment relies on sustained immobilization to allow the tendon ends to reconnect and stabilize. Understanding the indicators of a healed tendon is necessary to prevent re-injury and ensure a complete recovery.
The Standard Recovery Timeline
Healing a mallet finger injury requires a period of strict, continuous immobilization of the DIP joint using a splint. For a soft tissue injury, this period typically lasts for a minimum of eight weeks, worn day and night. If the injury involves a bony avulsion, where the tendon pulls a fragment of bone away from the finger, the required continuous splinting time may be slightly shorter, often around six weeks.
The splint must keep the fingertip in full extension to allow the tendon ends to form a stable scar tissue bridge. Bending the DIP joint, even slightly or briefly, can disrupt the fragile healing process, effectively restarting the entire timeline. This sustained positioning allows the tendon to reattach to the bone or for the bone fragment to re-fuse.
During the initial splinting phase, the tendon is actively healing to regain tension and function. This timeline is an expectation for uncomplicated cases, and individual rates of healing can vary based on factors like age, compliance, and injury severity. Medical supervision is important throughout this phase.
Physical Signs That Healing Is Complete
The definitive confirmation of a healed mallet finger occurs when the fingertip can be actively straightened without assistance immediately following splint removal. This assessment is usually conducted by a medical professional or hand therapist at the end of the prescribed immobilization period. The primary sign of success is the ability to maintain full, active extension of the DIP joint against gravity.
The most telling sign that healing is incomplete is the immediate return of the “droop” or a noticeable extensor lag in the fingertip after the splint is taken off. Any inability to keep the joint fully straight indicates that the tendon has not achieved the required stability and may necessitate a return to full-time splinting. The newly healed tendon must be strong enough to withstand its own resting tension.
Beyond the movement test, other physical indicators suggest the acute phase of recovery is complete. Swelling and redness around the DIP joint should be significantly reduced or absent, although some mild puffiness can persist for a few months. Additionally, the pain or tenderness that was present immediately after the injury should no longer be felt when the joint is gently palpated.
A medical professional’s confirmation is necessary before transitioning to the next phase. They assess the joint for stability and determine if any residual extension lag is acceptable. Even with successful treatment, some individuals may retain a minor extensor lag of a few degrees that does not affect the overall function of the finger. This final check ensures that the tendon has matured sufficiently to begin controlled movement.
Gradual Return to Activity
Once a medical professional confirms the tendon is stable, the next phase involves a gradual transition to unrestricted activity. This period is initiated with a weaning process where the splint is worn intermittently rather than continuously. It is common practice to continue wearing the splint at night for an additional four to six weeks to protect the finger during sleep.
During the daytime, the splint can be progressively removed for longer periods. It should still be worn during activities that carry a high risk of re-injury, including heavy gripping, manual labor, or any sport where the finger could be jammed or struck. This minimizes the chance of accidental forceful flexion.
Rehabilitation focuses on gentle, active range-of-motion exercises to restore flexibility and prevent stiffness in the surrounding joints. These exercises involve actively bending and straightening the finger within a pain-free range. Passive stretching or forcing the joint should be strictly avoided, as the maturing tendon can be easily damaged.
Patients must remain vigilant during this weaning phase. If the tip of the finger begins to droop again, the continuous splinting protocol must be immediately resumed. Full return to impact sports or activities that place significant stress on the fingertip is usually advised only after a total of 10 to 12 weeks from the start of treatment.