Discover the SECRET to Helping Your Patients Mallet Finger Recovery
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[00:00:00] Mallet finger injuries can be some of the hardest injuries that you treat as a hand therapist. Now a mallet finger is that terminal tendon rupture. Basically a lot of times when they get jammed or something like that and it ruptures that tendon. I have one that's a mallet finger and it's on the small finger.
So it's even smaller. smaller than the small tendon, right? I have one that's a small finger and then one that's a bony mallet, meaning when she fell and she hit her finger, she has a small fracture along with the disruption. She actually had a pinning surgery. So here's a little video that I did with one of my patients who has a mallet.
uh, injury to the small finger. My name is Wong. I'm an occupational therapist and certified hand therapist. And inside the mentorship program, I share cases like this with my patients and discuss like what you could do in order to be able to think through your case and then provide the best [00:01:00] possible treatment and solution for your patients.
If you're looking for more help and more guidance with your cases, click the link below to see more about what the mentorship program is about. I know what you're thinking. Oh, you just need four to six weeks. Listen to what I have to say about this one. So, the most important thing about the mallet finger, right, is look, not everyone's the same.
You are very hypermobile. You see that? Like me too. Right, so what we want is because we know you're very hypermobile. You don't stiffen You don't stiffen like everyone else like if you read it and they're like, oh you stiffen between four and six weeks Because you're so loose jointed You need more time Right, so I would almost go all the way eight weeks with you before it mess around, right?
So the best thing about this splint, right, that I think is going to be now better than the cast [00:02:00] that we started with, um, is that you can wear it, you can wash your hand, and you don't have to take it off. The cast that you had, you couldn't get it wet, right? With this one, you can get it wet. You just wash it, just dry it, just kind of like shimmy it a little bit to let it dry, right?
Um, now you don't want at any point for it to fall down, right? So when you take it off, you have to take your thumb and hold it like this. So take your thumb with your other hand, like this one, like this, hold it like that. So you almost like have to, Yeah, there you go. You almost have to bend the knuckle and then hold it like, oh, you're so loosey goosey.
Oh my gosh, just don't, just don't take it off. Well, this pinky is also kind of, it's wonky too. Okay. Try it with this one. There you go. There you go. Right. So try it with this one now. All right. So yeah, if you have to take it off, I'm going to [00:03:00] practice with you on this one. All right, let me get one that fits this one.
So let's say What's this? Alright. That's, okay. Right? So, if you were to take it off, or to just shimmy it, like, you could,
So you want to make sure that the bar is down here. Because then you cannot bend it. This is loose on me, obviously. Let me get one That is this size Okay. Oh my god. Yeah, right so if you were to Shimmy it off like try it on this one, right try try it with this one You can turn it a little bit see how you can turn it and just let it dry Oh, yeah, let it dry and then put it back.
This is a little tight on me You actually want it to be tight but if you were to do If you were to take it off, you [00:04:00] have to make sure that you take it off without it going down. Yep, just like that. Right? And then when you slide it on, you have to make sure that when you slide it on, it doesn't, yeah.
Just like that. Boom. Right? There you go. Just like that. Key thing is, just don't take it off. Obviously, if it falls, if it starts to shimmy off or you just want to air it out just a little bit, you can twist it. You can just do a little turn, just take it off a little turn. Just keep it straight. For you, I would just keep it on for another four weeks.
Alright? Now, you can get this type of tape anywhere. This is called transpore tape. You can get it at the drugstore. It's just a clear tape. And what's great about it is it's easy to come off, right? And [00:05:00] so, let's say you're taking it off, you can put it on, you can slide it off, right? You actually are fine as long as you don't bend it.
So if you were like this and you slid it off, you see it doesn't move. That's what I was testing, that's what I was testing when I was sliding it off and I was like, Let me put it in what we call a straight position. This is called the straight fist, right? So if I were to slide it off, I'm going to just show it with this one, right?
So put your finger like that. If you were to slide it off, you would keep your hand down like this and you would, you see that? Okay. Then you want to put this piece of tape, right? And then that tape will hold you. It doesn't hold everybody, but it's going to hold you. That's why I was testing it. It would hold you because you're very loose jointed.
I have someone else who's like real, real stiff with a mallet and it's different for her, right? But for you, you could use this tape, [00:06:00] right? And you see how it'll straighten you up and it'll keep you straight. So you won't mess up that, like. Reattachment, right? This is all to help avoid having a surgery. If they do the surgery, they would pin you and you'd wait another eight weeks.
That's the shit of a mallet finger. You can't help it. It's just, it's got the smallest little tendon. That, that one tendon is made of three little strings. And that's what they call the terminal tendon. That's the one you tore. Right. Um, for you, we're trying to avoid it because someone who's as hyper mobile as you are would develop a swan neck.
Because that's what I'm working with right now. Someone who has it and it's already developed it because she's very loosey. She's very loose jointed hyper mobile as well. So you're very hyper mobile, right? So, um, but yeah, so you want to put if you have to take this off for whatever reason, it's irritated.
It's, um, You know your skin or you just have to [00:07:00] take it off for a minute to wash it got dirty got nasty or whatever Just take it off and put it right and then um, i'm just going to leave this This tape here on this finger And then if it gets nasty you just take it off Right and you can put another piece and it's just going to ensure if one or the other But you want something hard this tape is not going to last it only lasts for like Like a little while Right, but it's gonna get carty, so.
You want me to take it off? I can take it off. Uh, I might take it off. I'm using my Can the tape get wet? No, I mean, it's gonna get wet, it's gonna get gross. Right, so, here we go. So, relax your finger.
Here we go.
Tape off. Your [00:08:00] finger. Straight. Slide this on. You're so loosey
goosey. You're so loose jointed. Does that hurt? Yeah. Alright, there. So the only exercise you're going to do is squeeze. Yeah, so stay straight. Squeeze. Squeeze. Do you have a Do[00:09:00]
you have a phone? Yeah. You have a Yeah. I'm using mine, so Okay. Alright, there you go. Put your hand like this. Alright. And then squeeze it. Uh, now you have feedback into that, right? You feel how tight you can be? Alright, and then relax. Alright, and then squeeze. Yep. So, We need to stiffen this even further, but we're going to strengthen this one to come down so it doesn't pull on this one.
I'm doing a voiceover right now, but I just wanted to show you that I'm still doing the [00:10:00] exercises. I'm trying on different splints. I'm trying different sizes. And I want to give him something that he can continue to use because I'm not going to see him for about three to four weeks because I want him to continue wearing it.
So all of this is a part of the therapy session. This is what people are coming to you for as a hand therapist in your area, as it has as the hand expert. So these things are just as important as. It's the doing that sometimes we get stuck on, right? So I didn't want to just cut it out because it's a little repetitive and boring, but anyway, hope that helps.
Don't lose it. Um, just don't lose it. And the reason why I like this, I can make you a splint as well, um, it's just, it's not as breathable as this one. Right? So, um, I just want you to wear it. Just keep wearing it. [00:11:00] In this video, I decided after using a cast for a little bit, um, I decided to go with an oval 8 or a figure 8.
And one of the reasons why I did that and I use a prefab over a custom fitted one because you can do either one. I was just looking for something that was going to be low profile for him and something that he can wash his hands. There used to be this material, um, that you, it looked like this little mesh, but you could use a heater to heat it up and it would give you the same feel as a cast, only it was Like you could wash your hands and stuff like that.
Well, they no longer make that so now we're stuck with just casting material, oval aids, or Split material and you got to try some of them to see what fits your patients. Unfortunately, it's not a like Just it's the same for everybody, right? [00:12:00] Um, I've done the casting with this patient. I've done the splint.
The splint actually because of how hypermobile he is, he can kind of come out of it too much. So we decided to go ahead and try the oval eight and see how he's doing. Already is looking pretty good. Um, the other thing that I did that you might I'm not sure if I showed it on this video, but I just use a little bit of transport tape.
Transport tape is harder than paper tape and it's definitely harder than kinesio tape and it's just a way that I can put it on and to ensure that the, you know, the finger doesn't fall down and I'm trying to teach him what to do as well because You don't have to come to therapy like very frequently for a mallet finger, but you definitely need to come to therapy for follow up.
So depending on your patient's um, need, you can make those recommendations. Now for that scenario specifically, I don't need to see him for a few weeks in between, so I was [00:13:00] teaching him a lot. For my other mallet finger who's already with the swan neck deformity and adhesion. It's a little bit more involved and it's a, uh, a fracture with the mallet.
So it's a bony mallet. She's coming in once a week because she needs a little bit more help. So it varies depending on your patient's need. So definitely take that into consideration.
