Mallet finger injury

Ergonomics and Posture for Classical Guitarists, Aches and Pains, Injuries, etc...
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Bertran
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Mallet finger injury

Post by Bertran » Sun Apr 28, 2013 7:38 pm

Dear members,

Recently, I already start one topic about my injury but at that time I don't know how to name it. Today I know, it is – MALLET FINGER. Beside mallet finger, there are other names for this is injury: basketball finger, dropped finger or extensor tendon injury. Once again, thanks all of you who give me some answers and encourage. But, inside that topic there is no new further answers so I conclude that maybe nobody (at this site) is familiar with this kind of injury. How it looks like you can see at picture „01_Mallet_finger“ (this is not my finger, I borrow the picture).

At this topic my intention is to describe my injury but also my process of recovery. Why? If you search through the Internet you can't find so much experience and recovery stories. Specially, if I say that my mallet finger is at left hand you can imagine that when injury happen I immediately know that playing guitar when I take guitar in my hands will be impossible.

So, I know that for more of you this topic is not subject of interest. Be happy of that; I am jealous at you :) Unfortunately, at the same time, I am sure that everyone with this injury be very interest for my story. I hope that maybe somebody I can help with it.

And this is an additional reason why I decide to start this topic: with injury like this you can maybe type at the keyboard but could you play classical guitar again? And when? At this moment I don't know,...
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Bertran
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Re: Mallet finger injury

Post by Bertran » Sun Apr 28, 2013 7:41 pm

After 1 day

So, back to the injury itself. Mallet finger usually happen when something hit your fingers for example (big basketball) ball. In my case, it is opposite:

I was playing football (10.04.2013) and inside the grass there was a very low roadside wall that I didn't notice. My body was sliding through the grass (with LH on the grass). I didn't expect anything but grass; I was looking at the other side. Suddenly I hit the roadside wall. My 2th LH finger implode and at the root of the nail - blue color appear. Later, I read that even blood can penetrate through the root of the nail (for injury like this).

But at that very first moment I don't know what was happen. I (and scorpion inside me) even continue to play! But after I finish the game, my fingers (2th and 3th) was puffy and I feel that pain is increase. I go to the hospital, I was afraid that something is broken. They took X-ray picture and say to me that with my 3th finger everything is ok but that some little bone (barely seen) is broken at distal interphalangeal joints (DIP) inside my 2th finger. But after some time everything will be OK. Also, they say that I can stabilize finger by myself or to go other hospital. I was little angry and don't like first solution so I go to other hospital!
I must say that at very beginning my finger was fat like sausage and that mallet finger is not easily evident. My finger was little bend, blue, puffy, I was afraid did I broke some bone,... but it is hard to say is it first phalange dropped or not. Anyway, at second hospital they give me stabilisation implaince made of aluminium with sponge (you can see it at picture „02_Aluminuium_splint“ (this is not my finger, I borrow the picture)).

I will carry that implaince one week,...
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Bertran
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Re: Mallet finger injury

Post by Bertran » Sun Apr 28, 2013 7:45 pm

After 1 week

I go again to the hospital (18.04.2013) but now new doctor (surgery specialist) come to see me. They put away my aluminium splint and he have some doubt. He sent me to get a new X-ray picture and while I was at the waiting room, even I can realize that my first phalange was dropped. At that moment I don't know explanation. Later, when I came to him (with a new X-ray picture) he said to me that everything is ok with my bones but my extensor tendon is broken. Diagnose is a mallet finger. He put me a new, improvised splint that you can see at the picture „03_improvised_splint“ (finally, this picture is my finger :)).

Since that day until today, I try to read as much as I can about mallet finger injury but I must say that beside a few theoretical artical, there is no experience stories, specially from the classical guitarist. Only a few posts and lot of questions.

Anyway, I read a lot of things that is good to know when you have a injury like this. Maybe is also good to put it down, too:
  • - There are two kind of mallet finger injury. One is when tendon just tear off (my case) and second one – when tendon take a piece of bone with it! There are a similar but different treatment for both case.

    - It is imperative to go to the hospital as soon as possible and stabilize the finger (I lose one day with physiatrist and wrong diagnose; I hope that it is not crucial).

    - Instead of improvised splint you can find (more comfort) stax splint that is easy to put on the finger and maintain. Because it is made of plastic it probably iritate your skin and it is normal. Of course, if you feel itch you must put some cream on it.

    - It is very useful if you can find a hand specialist who can see and treat a hundred of injury like this. Sorry to all doctors - I don't want to be a clever than they are - but I hear that even orthopeadist, physiatrist, general surgery doctors know a lot,... but they can not treat you with all of the care like hand specialist will.

    - To prove previous statement there is one good new advice. Finger must be stabilize in straight or even extra-extended position (tendon injury only). My new doctor say if I can find stax splint that I can replace his improvised splint on my own. But at the very beginning it is very important that you don't let phalange to fall down, not even for a one second of time! This is because a new fibers of tendon is at the phase of creation and they are try to catch the bone. If you allow your phalange to drop down you can destroy a new fibers and you are going back to the beginning of the recovery process. My doctor don't tell me that, just to change a splint. But I am sure that hand specialist will not forget to give me a warning like this.

    - Unfortunately I can't find a stax splint and right now I am still with my improvised splint. But if you ever must change your splint (for example after your bath) do it with keeping your finger straight; never let it to drop down. Also, at the night (when I am sleeping) I cover my whole hand with loose bandage to protect my finger.
My finger is now at stabilize and improvised splint, it look bad and purple but I feel no pain. Just wait for a new doctor's check control. And I ask myself is it possible to play a guitar again and dream about it. I feel that I have no 2th finger, it looks to me just like piece of wood,...
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Last edited by Bertran on Mon Apr 29, 2013 7:34 am, edited 1 time in total.

JohnPierce

Re: Mallet finger injury

Post by JohnPierce » Mon Apr 29, 2013 12:47 am

Bertran, thank you for posting this. It's important for people to be aware of the need for immediate and correct treatment of seemingly minor hand injuries like this one.

Is it possible that the "spax splint" you mention should be a "stax splint"? At least in the US, stax finger splints are very commonly used for "baseball finger", readily available both in medical supply shops and on the web, and quite cheap.

Best of luck with your recovery.

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Bertran
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Re: Mallet finger injury

Post by Bertran » Mon Apr 29, 2013 7:35 am

jwp

Yes of course :), my mistake, it is stax splint (not spax) - I correct it at my last post.
Thank you for correction and good wishes!

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mikfik
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Re: Mallet finger injury

Post by mikfik » Sat May 04, 2013 12:05 am

If you love playing the guitar you will work out a way to play no matter how many fingers you manage to destroy. You will just need to be creative and find a work around to the various problems you encounter. Being a machinist for many years I have messed up many fingers many different ways many different times. During the first week at one particular job I actually hit my left hand pinky finger with a real 5 pound mallet while my pinky was sitting atop a freshly surfaced ground piece of tool steel. Lots of stitches and to this day I have a huge scar that runs across my entire pinky finger but it still works well enough when I play and I seldom even think about it. After another accident at the same machine shop I herniated a disk in my neck and lost feeling in both my hands for a couple of years. It was a challenge but I learned to work around the problem and I never gave up playing while I waited for my surgery to be approved. I have limited feeling in both hands now but it doesn't keep me from playing and since I'm not a professional player it doesn't feel like a problem. Don't give up hope. If you have the will- you will find a way to deal with your funny finger.

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Bertran
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Re: Mallet finger injury

Post by Bertran » Mon May 06, 2013 7:47 am

Thanks mikfik. Your post sound very optimistic. At this state of injury I have no idea what can I expect in the future. So I try to write everything I know and what happens to me - maybe help someone else. I also beleive to myself and I will do whatever I can.
Night before injury I put a new string on my guitar and not even try them - they are waiting for me :)

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Bertran
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Re: Mallet finger injury

Post by Bertran » Mon May 06, 2013 7:53 am

After 3 week
Last week I was at hospital, at new check control. I found a hand specialist. He carefully take off my splint and say to me to keep finger straight! After that I wash my finger from medical bandage tape.
But I can see that my first phalange is now at straight position; it doesn't fall down! It is a good news because that means that new fiber of tendon are at creation phase and they are catch to bone's scar.
Doctor put to me the same improvised splint (so there is no need to attach a new picture) and I will see him again after 2 week.

About injury:
Of course, I don't want to be a hypochondriac, I am not pessimist (rather realist) and I don't think that this is a hard hand injury. In comparasion with open-broke or flaw bones (or something else) this is not injury that look scary. But,...
  • - at the same time when it happens, and when you see that your finger's phalange is dropped down it is pretty normal that you start to worry. When you remember that you playing guitar it is too normal that you start to be angry on gentle way :).

    - as much as I know right now, I expect that after 3 week leaving with splint (and without a guitar) I will carry that splint 3 or 5 week more. It is really a long time period! When I take off my splint at the and of this month I can not start playing with pieces that I leave at the day before injury. You must add therapy weeks, and period when you must return power (after muscle atrophy) and flexibility (with a "new" tendon") in your finger - it is obvious that this injury is not such a pleasent one (specially for musicians).

    - the main reason why a period of recovery needs weeks and months is because tendon is not like a bone that will fullfill with a calcium. Also, there is no blood that come to tendon, they are made of collagen. So, creation of a new tendon's fiber is slow and it is most important to stabilize your finger and not allow to tear off a new fibers at creation time.
All in all, and like many injuries, we must treat this injury at a proper way.

Leighton

Re: Mallet finger injury

Post by Leighton » Sun May 12, 2013 8:49 pm

If you can keep your finger straight after three weeks then that's fantastic. Don't try and push things though. As you point out, this is a nasty injury and tendons are tricky things. Have you managed to find a decent hand physiotherapist yet?

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Mick the Ramirez Man
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Re: Mallet finger injury

Post by Mick the Ramirez Man » Sun May 12, 2013 11:29 pm

Bertran,

I had mallet finger a couple of years ago, on my middle finger on my right hand. I injured it on Christmas morning in 2011. I went through the same thing you are, but I couldn't work with the splint on my finger. It took about 6 months to heal completely on it's own. It's completely normal now and I have no trouble playing Classical Guitar whatsoever.
:D
Ramirez 4NE, Ramirez R4 and Ramirez R1

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Bertran
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Re: Mallet finger injury

Post by Bertran » Mon May 13, 2013 10:13 am

Thank you Leighton,
I also hope that healing goes in good direction and yes - I have found hand physiotherapist in the same hospital. Like I said at previous posts (and you too) mallet finger looks simple but is nasty injury. When one know that at best he can not be able to play guitar two months and need additional months for fully recover it is very frustrating and ruin one's progress as guitarist.

Mick The Ramirez Man,
Thank you for your post. It is very interesting to read your experience. It is very encouraging.
Luckily for you and all of yours Ramirez guitars that everything is normal now. :)

This week I will go to a new check control and (might) I found out more,...

Kevin Clark
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Re: Mallet finger injury

Post by Kevin Clark » Wed Jun 05, 2013 8:16 pm

I now have a mallet finger , I'm devastated, left hand middle finger. The doc says to keep the splint on for 6 weeks! I did it whilst gardening, what an idiot! that'll teach me to use my hand as a shovel! My poor guitar is in it's case all lonely :(

JohnPierce

Re: Mallet finger injury

Post by JohnPierce » Wed Jun 05, 2013 9:58 pm

I should have thought of this before.... In both cases, the injury is to the left hand. That wouldn't prevent you from being able to practice with your right hand, would it? If you tuned to an open chord, or maybe a pentatonic scale, you could still get musical-sounding things out of it. Perhaps you could even learn to play a little slide guitar, either in the normal position or with the guitar flat in your lap. The point is to avoid losing right hand capability and stamina just because your left hand can't contribute for a while.

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Bertran
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Re: Mallet finger injury

Post by Bertran » Fri Jun 07, 2013 9:51 am

Jwp, thank you for a new advice – it make sence. Are you a physiotherapist?
Kevo62, I hope that this topic (and my dramma) can help you. Also, maybe it is good idea that you write about your experience. After 6 weeks you will be at the same situation like me right now. :)

After 2 month
First I must say that, at the meantime, I have one more control before 3 weeks but they just change my splint and put a new one.

Yesterday, after full 8 weeks, I finally put off a splint from my finger. My skin is ruin and peel, tip of my finger is spiky (because split push my flesh but this can be repair), I don't feel any pain in normal position. My first (DIP) joint is straight; I can bend it a little.

But, right now, I am not happy!! My finger is still look like a piece of wood and I don't have a flexibility. Of course, I expect that flexibility will be problem with my DIP joints and I know that therapy waiting for me. But I didn't expect that I will have a problem with my second (PIP joint)!!!

Something block my PIP joint and because of this I can't bend my finger and I feel a pain at PIP (!!) when I try to make a fist! With all healthy finger (without bending a DIP) I can touch my palm with tip of finger (anyone of you can do it without bending a first joint). But with this finger I only bend it in position like I have a little ball in my hand but no more than that. Some persons tell me that it is because tendon is now fat or maybe because I didn't use that finger and it is lazy now – but I don't know what to think.

I only know that I am concerned. :roll: Next week I will start with therapy and see what will be,…

Bertran

Johannes Lindstad

Re: Mallet finger injury

Post by Johannes Lindstad » Sat Jun 22, 2013 2:05 pm

What excatly happens to the bones inside the finger when you get a mallet finger? Can someone please explain?

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