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Aeitiology

1. Damage / division of extensor tendon to the terminal phalanx of finger involved
2. May occur if flake of bone avulsed from the base of the distal phalanx ("baseball finger") 

Approach

• As for any hand examination
• Place palm upwards

1. Look

   

   • Flexion deformity of distal phalanx of one or more fingers
2. Feel
3. Move
   • Active movement of finger - terminal phalanx cannot be actively extended
   • Passive movement - digit can be moved back into normal position (unless chronic)

Management

1. X-ray to exclude fracture
2. Splint finger for 6 weeks (in a mallet splint) to allow reattachment of tendon
3. If avulsed flake of bone greater than 1/3 width of joint space on the lateral x-ray it should be repositioned with Kirschner wire or other internal fixation device