Mallet Finger – Sudden hyperflexion of the fingers’ most distal joint as a result of being hit by a ball or getting caught in a sport’s jersey can result in avulsion of the extensor tendon as it inserts into the most distal bone at the tip of the finger. Patients usually experience acute pain and almost immediately notice a “droopy” fingertip. This droopy or mallet finger posture is the classic site of the extensor tendon avulsion which may also be accompanied by a small fracture.
Mallet finger injuries classically were treated by weeks of splinting the finger in a hyperextended position but this technique is often impractical and often fails. My preferred treatment uses a minimally invasive technique to percutaneously place a tiny stainless steel wire under x-ray guidance to internally keep the joint in an extended position to allow the tendon injury to heal properly. This method is very well tolerated and has proven to have a much higher success rate.
Ligament Injuries – Athletic activities and ligament injuries (or sprains) have forever been very closely associated. Most sprains respond well to the conservative measures of ice, elevation and rest. There are specific ligament tears that require occasional surgical intervention. Injury to a ligament at the base of the thumb called the ulnar collateral ligament is an excellent example. A tear of this ligament creates a condition called “Skier’s thumb”. Because of the local anatomy, a tear of the UCL can become positioned in such way that it would never be expected to heal with simple conservative care. MRI exams are often required to assess the severity of the injury and the need for surgery.
