The mystery of the missing mallet fingers

What was the first thing you noticed when you moved to Queenstown? Perhaps the paragliders landing on the school football field (while the kids play on as if nothing’s happening), maybe the endlessly creative ways tourist drivers find to use roundabouts, maybe it’s that the average mountain bike seems to cost more than the average car. It’s a bizarre and unfamiliar world for most new residents.

Hand Therapists are wired to notice different things. Take for instance Nicky De Carvalho, who recently moved from Tauranga to work with the Studio’s hand therapy team. One of the first things she noticed was: “Where are all the mallet fingers?”

If you’re not au fait with the hand therapists’ jargon, a ‘mallet finger’ is an injury to the extensor tendon at the tip of the finger. She says, “It’s where the tendon either ruptures at its insertion or it avulses a small piece of bone off at its insertion resulting in an inability to straighten the tip of the finger. The most common mechanism of injury is a blow to the end of the finger – typically from an awkward catch during a game of netball.”

missing mallets

Up north, she says, she’d typically a few mallet fingers each week; In Queenstown it’s only been a handful over the last few months. Which of course begs the question: why?

Is it just that we play less ball-sports? Perhaps the hardened southerners have a “concrete pill and walk it off” approach to finger injuries? Or perhaps there’s a lack of awareness among front line healthcare workers as to the best practice way of managing them.

De Carvalho says, “A mallet finger will not heal itself without use of a splint to hold the tendon ends (or bony fragment) together while healing. A hand therapist will make a custom made splint that supports the finger in the correct position and guide the patient through the healing process and assist you to wean from the splint and regain strength and movement.”

She says it’s quite possible some general practitioners or emergency department staff put on an a generic splint (often very poorly fitting) and then send the patient away not knowing what we offer at hand therapy”.

“I’ve seen pts come in with these splints upside down and having worn the splint sporadically, which just means lost time – and the longer we leave it the less chance of it healing well.”

If you find one of Queenstown’s missing mallet fingers you can book an appointment with the Studio’s Hand Therapy team here. Initial appointments are surcharge free, follow-ups cost the client $15 (and custom-made splints are fully funded by ACC) overall it’s a very small price to pay for a finger that works properly.