mallet finger still droops after splinting

An x-ray will also show whether the injury pulled the bones of the joint out of alignment. endobj >> The result is that the tip of the finger droops into a flexed (bent) position due to the absence of an effective extensor tendon. /Subtype /Type1 >> Do not take more than the amount recommended on the bottle or by your provider. can get it. The splint is then worn for shorter periods that include nighttime splinting for six more weeks. >> Care must be taken to keep the skin dry under a splint. /.notdef/exclamdown/cent/sterling/currency/yen/brokenbar/section /Subtype /Type1 Sometimes, mild drooping of the last joint in all the patients fingers is seen normally in some people. /F2 4 0 R An inability to straighten your fingertip. Mallet finger is an injury to the end of your finger that causes it to bend inwards towards your palm. There are several types of splints used to treat mallet finger, many of them fabricated by hand therapists. /F1 3 0 R Advice from a Certified Hand Therapist: What is a Mallet Finger and How is it Treated. 15 0 obj A temporary splint is applied with two pieces of tape. However, any action that bends the joint further than it is meant to bend can cause mallet finger. Necessary cookies are absolutely essential for the website to function properly. This means that it must be worn while bathing, then carefully changed after bathing. Copyright 2022 Mallet Finger On Demand by Virtual Hand Care, LLC. For that to happen, you must keep your fingertip immobilized every hour of every day. DeLee, Drez, & Miller's Orthopaedic Sports Medicine. To restore function to the finger, the splint must be worn full time for 8 weeks. This is a figure-eight splint that you wear around the PIP joint all the time for several. /Encoding 16 0 R If the joint flexes even for a moment with the splint is off, it will disrupt the healing and the process will take longer. For 3 to 4 weeks after the initial splinting period, you will gradually wear the splint less frequently perhaps only at night. If this is the case, then your finger will not be placed in hyperextension. /BaseFont /Courier-BoldOblique /XObject 18 0 R The long, ring, and small fingers of the dominant hand are most likely to be injured. As the splint dries, you must keep your injured finger straight. 0000000016 00000 n This is due to laxity or flexibility of tissues of the individual instead of injuries. The tendon eventually joins with scar tissue, but in the stretched position. You may need to wear a splint for different lengths of time. This injury is most commonly in baseball players, but it anyone who plays a sport that involves hard balls (basketball, volleyball, football, etc.) /Type /Font Most mallet finger injuries can be cured without surgery. !ZK?T3K'P,y }\zy{GB8NGCin(q?F6[J^73n|DhaG%d~nrI)*'cc; After completion of the initial splinting program a skilled hand or occupational therapist is needed to restore motion and return the finger to a healthy state. Example of mallet finger with drooping of tip. 0000004669 00000 n /Font << Letting your fingertip droop or bend may mean you will have to wear your splint even longer. You may need to wear a splint for different lengths of time. The force can cause either the tendon or broken-bone type of mallet finger. This category only includes cookies that ensures basic functionalities and security features of the website. The tendon that attaches to the tip of your finger bone on the back side helps you straighten your fingertip. Mallet finger most often occurs when something hits the tip of your straightened finger and bends it down with force. hb```c``me`e`ned@ A+I@Zdjvd5AR@ bV`mH@ YV000`mHlzg;;D./=-T)asiK/Me8 3C.H310pf0|ro0 -^ 16$'. 0000302027 00000 n A mallet finger that is up to three months old may require splinting in full extension for eight to 12 weeks. 0000011867 00000 n >> The extensor tendons on the top of the hand straighten the fingers. In a mallet finger, the fingertip droops: it cannot straighten on its own power. A mallet finger is an injury to the extensor tendon on the back of the finger, which is the tendon used to straighten the digit. The fingertip droops because the tendon that straightens the end joint is no longer attached to the bone and cant do its job. >> 0000008777 00000 n /Subtype /Type1 What to Expect Wearing a splint on your finger to keep it straight is the most common treatment for mallet finger. Green's Operative Hand Surgery. In rare cases a relatively large piece of bone breaks off, disrupting the joint entirely and requires surgery to correct the joint alignment. A custom-made splint that holds the tip of the finger very still must be worn continuously for six to eight weeks. An orthopedic surgeon should be consulted in making the decision to treat this condition surgically. /Encoding 16 0 R 9R @dV@KY4Y24q^%fjls4~9F#(P/gs*r*46Z C'49 959 95F#Hnn6 C'6C_X"Y?g,~O ~?'Y;dIP The tendon has several attachments on the back of the finger, including one just beyond the last knuckle that allows this last finger joint to extend (straighten). /Name /F3 If you prefer reading then lets get to it. Injuries can occur in a number of ways, but most commonly when a straight finger is stubbed and forced to bend suddenly at the joint near the tip. 0000012611 00000 n ] Youll need to avoid sports until youve completely healed. << Reproduced from The Body Almanac. This is a common reason why mallet fingers are not healed. (Top) A rupture of the extensor tendon. endobj 0000013732 00000 n Mallet finger, known as drop finger or baseball finger, is an injury to the tendon that straightens the tip of your finger (or thumb). In rare cases, despite appropriate care, the tendon simply doesnt heal. The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. Most doctors recommend seeking treatment within a week of injury. This can keep down the swelling and reduce the pain. After the pain of the initial injury you may experience: No. The injury frequently affects a finger on the hand you use the most (your dominant hand). However, there have been cases in which treatment was delayed for as long as a month after injury and full healing was still achieved. Continued pain and repeated injuries are more likely due to a problem in the joint. /Encoding 16 0 R It is mandatory to procure user consent prior to running these cookies on your website. For some patients, the splinting regimen is very difficult. %PDF-1.3 So if your middle joint is not splinted in the correct position then your fingertip will droop. It is important that you do not return to sport or manual work without the splint on for 12 weeks after treatment commenced or else you are at risk of re-injuring the finger. This is a big reason why your finger should be splinted in hyperextension. Unfortunately, the problem wont fix itself and if its ignored it can cause long-term pain, stiffness and deformity of one or both finger joints. 4 0 obj 0000010310 00000 n Advertising on our site helps support our mission. You are looking for assistance on what to do, how to progress your exercise program to make youre your finger does not droop again. Stay in contact with your healthcare provider and let them know about any additional problems or concerns. The doctor must carefully evaluate and treat this injury in children, so that the finger does not become stunted or deformed. The second type is a broken bone at the extensor tendons attachment site that prevents the tendon from pulling on the whole bone. 8s1B Wgz4jA*u,9lh u cB} fm6cv\IER sz; z4,9r=Y-8 -1*:K0s5j\ . JFIF C It is important that you do not return to sport or manual work without the splint on for 12 weeks after treatment commenced or else you are at risk of re-injuring the finger. Youll then wear your splint day and night for a minimum of six weeks. Keep your finger straight at all times. hm8DBbB9vU)A!36aYlu2x. /cedilla/onesuperior/ordmasculine/guillemotright/onequarter/onehalf/threequarters/questiondown [1] Reproduced with permission from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. /BaseFont /Courier-Bold 0000172262 00000 n During the examination, your doctor will hold the affected finger and ask you to straighten it on your own. A mallet finger is a deformity of the finger typically caused by injury. This content is written, edited and updated by hand surgeon members of the American Society for Surgery of the Hand.Find a hand surgeon near you. It can be especially tempting to remove your splint while showering. wikiHow is where trusted research and expert knowledge come together. Mallet fingers can happen when an object (such as a ball) strikes the tip of the finger or thumb. Because there is nothing else pulling the finger straight, the finger droops down. stream An open mallet finger starts with a sharp cut or laceration, which goes through the tendon and down to the bone, over the last joint of the finger. Extensor tendon injury. You may need another x-ray of your finger. Dont ignore a drooping finger, the treatment is simple and very effective if started as soon as possible. /Encoding 16 0 R The flexor tendons on the palm side of the hand bend the fingers. 1 0 obj Most people recover from a mallet finger injury and regain full or near-full use of their finger without surgery. This can delay the healing process and you might need to wear a splint for a longer period of time. If a fragment of the distal phalanx was pulled away when the tendon ruptured, or if there is a larger fracture of the bone, it will appear in an x-ray. /Name /F6 X-ray shows that a piece of the distal phalanx bone broke away with the tendon. Injuries with even a little swelling or bruising may have a fracture.X-rays or ultrasound images can be used to show if there is a fracture causing the finger deformity. Hand Therapy, Health Basics, Rehabilitation Although it is also known as "baseball finger," this injury can happen to anyone when an unyielding object (like a ball) strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. About OrthoInfoEditorial Board Our ContributorsOur Subspecialty Partners Contact Us, Privacy PolicyTerms & Conditions Linking Policy AAOS Newsroom Find an FAAOS Surgeon. You should go to the emergency department when you get injured. << %%EOF >> On the flip side, instead of hyperextended, your fingertip could be resting in the splint with a slight bend to the fingertip. By clicking Accept, you agree to our use of cookies. 0000006537 00000 n You also have the option to opt-out of these cookies. startxref You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment. A mallet finger is an injury that should be treated, but you should be able to go about your daily life. Mallet finger is an injury. They will show you exercises to maintain motion at the middle joint while the end joint is held still. 0000129787 00000 n Treatment may include immobilization, surgery, physical therapy, and medications. xq5csOmv8L"8z&gj\03TnxO_~2/;]~~Z3}sn>?_M?T[>/ FM_~%H$U vHPZ&Ud%C{?'~/f6KUnj{lnl_~Fg2-6jvNV_R)?-2?UkGv.qx[VD3lg90?/_y4 g) As some individuals do not see the hammer resemblance, some have proposed changing the name to drop the word "finger" due to its appearance. endstream endobj 208 0 obj <>/Filter/FlateDecode/Index[12 160]/Length 27/Size 172/Type/XRef/W[1 1 1]>>stream Even though you may be in the right position from the start, there can be a lot of reasons why you may not STAY in the correct position. A step that shouldnt be missed if you dont want your future self to be asking why is my mallet finger not healed? The last knuckle of the finger or thumb is no longer able to straighten and the tip of the finger droops. /Egrave/Eacute/Ecircumflex/Edieresis/Igrave/Iacute/Icircumflex/Idieresis Wearing a splint on your finger to keep it straight is the most common treatment for mallet finger. It is also known as "baseball" finger . Your splint is made of hard plastic or aluminum. References. If you have a suspected mallet finger injury the first step is to visit your GP for an x-ray. In a mallet injury, when an object hits the tip of the finger or thumb, the force of the blow tears the extensor tendon. /Name /F12 Your primary healthcare provider may be able to treat your mallet finger. Even after eight to 12 weeks of splinting, it might be another three to four months before your mallet finger fully heals. >> However, it may be painless and only bothersome during certain activities. /Encoding 16 0 R /Encoding 16 0 R 6 0 obj A droop, or lag, of 10 to 15 degrees is considered normal after a tendinous mallet finger. Surgery may be considered when a mallet finger injury has a large bone fragment or the joint is not properly aligned. Rotator Cuff and Shoulder Conditioning Program. After your x-ray confirms the type of mallet finger you have then position of your finger in the splint can be determine. Like all injuries, you can get mallet finger again after it heals. /Type /Font /Type /Font But it should not be so tight that it cuts off blood flow. All material on this website is protected by copyright. /degree/plusminus/twosuperior/threesuperior/acute/mu/paragraph/periodcentered 16 0 obj The cause of this condition is an injury to the extensor tendon, which straightens the end joint just before the fingernail. 0000028533 00000 n >> /F8 10 0 R A mallet finger can also result from a deep cut from a knife or sharp object on the back of the finger. This will result in a slight droop. /F12 14 0 R /Height 132 AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. The fracture may be only at the tip of the bone at the attachment site. Getting your plaster off is just the beginning, 2 Convenient locations: Calamvale & Greenslopes (see Contact Us for more details). We do not endorse non-Cleveland Clinic products or services. This is important so the doctor knows how you should be splinted and for how long. Thanks a lot. /onesuperior/grave/acute/circumflex/tilde/macron/breve/dotaccent Your finger will also be painful and swollen. If you have a bony mallet finger, this will show up on an x-ray. ",#(7),01444'9=82. /dieresis/copyright/ordfeminine/guillemotleft/logicalnot/hyphen/registered/macron Minor complications developed in 38 out of the 84fingers splinted (45%). This information is provided as an educational service and is not intended to serve as medical advice. hbbbg`b``3I0 We use cookies to make wikiHow great. The process of healing will take some time. With injury, the tendon can tear or detach from the finger bone. endstream endobj 181 0 obj <> endobj 182 0 obj <>stream More than likely, you wont get a noticeable droop if you were placed in slight hyperextension in the splint. /Encoding 16 0 R endobj In these cases, surgery is done to repair the fracture using pins to hold the pieces of bone together while the injury heals. A slow progressive program is necessary to slowly stress the tendon. If there is a piece of bone pulled off, your healthcare provider may order another X-ray after a week or two of splinting to check on the appropriate position of the bone fragment and the healing process. "This article provided me with encouragement that help can be gained from using a splint even after a partially, "I found out important info about splints that are used for mallet finger.". In these cases, the doctor may decide to insert a temporary pin across the fingertip joint to hold it straight for 8 weeks. This is especially true in injuries that require surgery. 8 0 obj /Subtype /Type1 endstream endobj startxref Now say youve done everything mentioned above and that is why you are here. /egrave/eacute/ecircumflex/edieresis/igrave/iacute/icircumflex/idieresis Removing your splint even once, without support, can undo all that healing goodness. endobj CT scans may be ordered if there are many fracture fragments. If you have mallet finger, youre unable to straighten your finger, it droops at the tip, is painful and looks bruised and/or swollen. That's perfectly fine. from the American Academy of Orthopaedic Surgeons. Medical Ask an Expert Medical Questions What causes swelling in mallet finger after 10 weeks in a splint? Excellent article and its translation. /Subtype /Type1 The finger may be painful, swollen and bruised, especially if there is an associated fracture, but often the only finding is the inability to straighten the tip. Youll need to know if the tendon was torn, if it detached from the bone or if theres a fracture. Skip navigation About us Resources News Careers Contact us Easy read Charity After six to eight weeks in the splint full-time, a gradual weaning process occurs under the guidance of your therapist. There is no fracture but only the tendon is pulled off your fingertip bone. This normally does not cause any problems . Why is my Mallet Finger Not Healed?- is the number 1 question I get asked. /Subtype /Type1 But if your joint is misaligned, your finger is broken or there are bone fragments that result in an unstable joint, your injury is considered complex and may need surgery. Skiers Thumb, more common than you think! /BitsPerComponent 8 endobj >> I will walk you through how to safely progress exercises so that you can prevent drooping from coming back. Mallet finger is a common hand injury. In: Miller MD, Thompson SR, eds. If there is good positioning of the bone fragments, new bone will fill the gap. But you may develop arthritis if the tendon pulls off a piece of bone from the joint surface and it remains displaced. There are several types of splints. Your doctor will most likely order x-rays of the injury. Then upon removal of the splint, your finger could droop. If you have a bony mallet, you want that bone to heal. A trained professional should make your splint to make sure it fits correctly and your finger is in the right position for healing. 0000039225 00000 n When youre injured you should immediately: Long-term treatment involves putting your fingertip into a splint and keeping it there for a minimum of six weeks while your tendon heals. This is called an avulsion injury. Make a temporary splint. Video of the Day Step 2 Stretch the muscles of the fingers actively. The splint is made of moulded plastic and constructed specifically for your finger by a hand therapist. %%EOF The finger is usually painful, swollen, and bruised. Doing this will allow your tendon to meet to the tip of the finger. 0000011139 00000 n F: (07) 3124 6245 And to make sure you dont actually have a swan neck deformity. Each time you take it off and bend your finger tip, it can lengthen your recovery time. 5th ed. 10 0 obj For example, if you have a tendinous mallet finger, your finger needs to be placed in a little bit of hyper extension in your splint. /Encoding 16 0 R 11 0 obj 43 0 obj <>stream This x-ray of a mallet finger shows a broken finger, where a piece of the bone has been broken off. Wrap adhesive tape around your finger and the object so that the tape holds your . Your doctor may also schedule additional visits over the course of the 8 weeks to monitor your progress. Mallet finger is an injury to the thin tendon that straightens the end joint of a finger or thumb. These cookies will be stored in your browser only with your consent. For this type of surgery, your surgeon may make a small incision in your skin or to insert a pin or wire to keep your fingertip straight. /Subtype /Type1 Long tendons extend from these muscles through the wrist and attach to the small bones of the fingers and thumb. We also use third-party cookies that help us analyze and understand how you use this website. Your treating therapist will show you how to safely wash the finger and reapply the splint without bending the fingertip. /eth/ntilde/ograve/oacute/ocircumflex/otilde/odieresis/divide Mallet finger usually is caused by an. This will result in a slight droop. %PDF-1.5 % Injury to the extensor tendon at the DIP joint, also known as mallet finger ( Figure 2), is the most common closed tendon injury of the finger. Sometimes people assume the injury isnt serious and hesitate to get checked out. /Width 101 You will likely be able to return to your normal activities or sports, as long as you wear your splint all the time. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. This condition can also happen when the small joint is forcefully bent during use such as lifting heavy objects that force the joint into a bent position. /Subtype /Type1 However, some slight droop, bumpiness, or contour difference in this finger can be permanent. << This is called the mallet finger test. 17 0 obj Mallet, which means hammer, was the term used to describe the hammer-like deformity that occurred in sports-related injuries in the 1800s. Diagnosis: A mallet finger refers to an injury whereby the extensor tendon to the tip joint (distal interphalangeal) of the finger is disrupted or torn. It is easy enough to get started with a splint your doctor gives you, or you might be tempted to use a splint that you found at the drugstore. Youll need to wash and dry the splint once a day (keep your finger straight when you do it). /Resources 4. Most can be completely treated with non-removable finger splinting until the tendon heals itself or the bone seals the fracture.If theres no cut or laceration, a cold treatment (ice) can be applied to bring down the swelling. Specifically, the extensor tendon is injured, resulting in the inability to actively extend the finger at the distal interphalangeal joint (DIP). Tendons attach your bones to your muscles, providing stability and motion. Ugh! /BaseFont /Helvetica-BoldOblique In fact, anyone can get a mallet finger injury, even from doing something as simple as making the bed. >> endobj But it can also occur when performing household activities if you strike the tip of a finger on an immoveable object such as a door or wall. /.notdef/.notdef/quotesinglbase/quotedblbase/.notdef/.notdef/.notdef/.notdef In children, mallet finger injuries may involve the cartilage that controls bone growth. Rehabilitation following mallet finger - South Tees Hospitals NHS Foundation Trust Mallet finger rehabilitation. A droop, or lag, of 10 to 15 degrees is considered normal after a tendinous mallet finger. Remember to take your pain medications as prescribed, wear your splint for a minimum of six weeks as instructed by your provider, and do your finger exercises. /F7 9 0 R Mallet finger can be either a direct tear to the tendon or, more commonly, a piece of bone that is attached to the tendon fractures away. You can buy these pain medicines at the store. Sometimes, blood can collect underneath the nail. Occasionally, a minor force such as tucking in a bed sheet will cause a mallet finger. If your mallet finger injury is more complex, your surgeon may need to surgically insert a small pin into your finger to hold the joint straight while it heals. 0000047509 00000 n Dont ignore a droopy finger. This gives the finger the appearance of a mallet or hammer. Your doctor may consider surgical repair if there is a large fracture fragment or the joint is out of line (subluxed). Talk to your healthcare provider about the best type for you. /Type /Font Right? What happens if there is still a deformity after the splint comes off . << If your tendon is torn or pulled off the bone, it should heal in 6 to 8 weeks of wearing a splint all the time. Take over-the-counter pain medications, if needed. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event, (https://www.assh.org/handcare/condition/mallet-finger), (https://www.nhs.uk/conditions/mallet-finger/), (https://orthoinfo.aaos.org/en/diseases--conditions/mallet-finger-baseball-finger/). /Name /F11 If your young child has mallet finger and doesnt get treatment, their finger may not grow properly. /Subtype /Type1 Safe and Simple Exercises For Your Mallet Finger Injury. >> Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. 7 0 obj 0000013834 00000 n /Encoding 16 0 R /dieresis/.notdef/ring/cedilla/.notdef/hungarumlaut/ogonek/caron A drooping finger is more commonly known as a Mallet finger injury. Afterwards the end joint of the finger doesnt straighten properly. In fact, it is important to make sure that you are splinted correctly with the bony mallet finger because too much hyperextension can be very painful. With injury, the tendon can tear or detach from the finger bone. Finger swelling can fluctuate causing the splint to slide around and sometimes fall off (g. wearing your mallet finger splint 24 hours a day, 7 days a week. /F4 6 0 R ?7J%h NDC)xf|nY?YeNSw(T5B9c2?z_enl{S?Q8gP;D{}v*aOZvlZwMur:O[3ac/O,)@+-TJh+A[ abeKoOz~D7i.0zy|}0 (? Using the uninjured hand, straighten the fingers of the injured hand. Surgery is rare. << A splint will often be worn at night for a month to prevent recurrence of the deformity. Most patients with mallet fingers can be treated successfully with a splint, even if there is a fracture. This is a big reason why your finger should be splinted in hyperextension. 0000013662 00000 n In these cases, wires or small screws are used to realign the joint (see Figure 4). endobj 0000001352 00000 n << 0000001530 00000 n After a minimum of six weeks and adequate healing, your hand physiotherapist may develop a stretch and exercise routine to help strengthen your finger. If you dont treat your mallet finger injury, your finger could become stiff and even unbendable. Editorial team. /Type /Font 0000007763 00000 n 209 0 obj <>stream Step 1 Stretch the muscles of the fingers passively. It is not common to treat a mallet finger surgically if bone fragments or fractures are not present. Board Certified Family Medicine Physician. 0000001688 00000 n A mallet finger injury requires medical treatment to ensure the finger regains as much function as possible. endobj << This article has been viewed 379,183 times. The tendon has a better chance of scarring and therefore, healing. Last reviewed by a Cleveland Clinic medical professional on 09/23/2021. After realizing that youre unable to straighten your finger, your healthcare provider may require an: Both immediate and long-term treatment is essential to healing. There are several types of splints used to treat mallet finger, many of them fabricated by hand therapists. He received his MD from the Medical University of the Americas in 2012 and completed his residency in Family Medicine at the Robert Packer Hospital. Constantly removing your splint will not allow for strong healing. This meanswearing your mallet finger splint 24 hours a day, 7 days a week. The resulting drooping fingertip looks a bit like a mallet or hammer, so we call it Mallet Finger. Also known as "baseball finger," it is an injury that is typically sustained while playing sports. Finger swelling can fluctuate causing the splint to slide around and sometimes fall off (gasp). 2 Convenient locations: Calamvale & Greenslopes (see Contact Us for more details), P: (07) 3344 7942 Either one results in an inability to extend the distal interphalangeal (DIP) joint. 172 0 obj <> endobj This helps to determine whether there has been a bony injury or tendon injury. This cut can go down to the bone and can divide the extensor tendon away from the bone. We advise that you monitor the skin under your splint to avoid skin breakdown. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010. After that, you will need to wear your splint for another 3 to 4 weeks, at night only. The muscles that move the fingers and thumb are located in the forearm. A splint holds the fingertip straight (in extension) until it heals. endobj All rights reserved. The wean should occur over a 1-month period. If you are using a different splint, put your finger in a plastic bag or use a glove. This condition is sometimes called baseball finger because it can happen so often when catching a baseball bare-handed. These types of injuries may lead to chronic infection or abnormal growth of the distal phalanx.Mallet fingers with exposed bone or with a cut tendon should be treated urgently to prevent infection.If a mallet finger is not treated promptly, the finger may not function properly and may cause pain. Mallet finger is a painful injury with a simple treatment. Can I Play Golf or Play Sports with a Mallet Finger? /BaseFont /Helvetica-Bold Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. $.' /Thumb 20 0 R The fingertip will droop noticeably and will straighten only if you push it up with your other hand. 0000029258 00000 n Secondary Outcome Measures : DASH score [ Time Frame: 4 months ] Secondary Study Questions: Repeat 10 times. Baseball finger - aftercare; Drop finger - aftercare; Avulsion fracture - mallet finger - aftercare.

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