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Tendons and ligaments have different roles
The tendons transmit the force of the muscles to bend or straighten the fingers. Ligaments connect bones and stabilize joints. A small visible injury can affect one of these structures, sometimes with a bone fragment. The external appearance is not enough to judge severity.
This guide distinguishes between mallet finger, skier's thumb and loss of movement after an injury. These situations do not require the same exercises. It is used to understand the need for evaluation and the instructions received, not to identify the affected tendon alone. A finger that is still moving may also have a partial injury.
Understand the picture
Three injuries, three protection questions
Mallet finger
The mechanism that straightens the fingertip often needs to be protected in continuous extension.
Skier's Thumb
A ligament stabilizing the pinch grip may be partially or completely torn.
Tendon wound
The skin may hide a deep injury requiring a specific protocol.
Mallet finger: the tip no longer straightens
Mallet finger occurs when the tendon that straightens the last joint is ruptured or tears off a small fragment of bone. This can happen after a ball received on the tip of the finger, but also after a seemingly modest movement.
The last joint remains bent and you cannot actively keep it straight. There may be pain and swelling. An x-ray looks for a bone fragment and joint alignment. Have this loss of movement evaluated without waiting for it to disappear with exercises. Straightening then folding several times to test the finger does not promote repair.
Chapter sources [1]
Special protection for the mallet finger
Treatment often involves an orthopaedic splint maintaining the end joint straight continuously for several weeks, frequently six to eight depending on the injury. Some fractures have a different timeline. The team specifies the duration and shows how to cleanse the skin without allowing the fingertip to bend.
It is essential to respect this position during the prescribed phase, including when changing the orthopaedic splint. If the finger accidentally bends, contact the team for instructions on how to proceed; don’t decide alone that this has no consequences. Monitor skin and fit. Other joints can often move as instructed, but the protected joint should not follow our general exercises.
Chapter sources [1]
Skier's thumb: a stabilizing ligament
A fall with the thumb forced away from the hand can damage the ulnar collateral ligament of its base joint, near the corner between the thumb and index finger. This ligament stabilizes the pinch grip. The injury can occur while skiing, but also during other falls or sports.
The thumb may be swollen, painful and less stable when holding a key or object. Do not try to spread it sharply to check the ligament. The medical examination looks for a partial, complete or displaced tear. An x-ray and sometimes an ultrasound can help. A displaced injury may not heal properly in its position and requires specialist advice.
Chapter sources [2]
Protect the thumb according to the injury
A partial tear can be treated with appropriate immobilization, often for several weeks. A complete or displaced tear may require repair. The decision depends on stability and examination, not just the intensity of the pain or the size of the bruise.
During protection, avoid strong clamping, twisting and unauthorized spreading. After removal of immobilization, mobility and strength gradually resume according to the program. An splint can sometimes be used when returning to sport. The timetable of a mallet finger does not apply to the skier's thumb: the structures and constraints are different.
Chapter sources [2]
A cut or suddenly lost movement
A wound on the back or palm of a finger can affect a tendon, nerve or vessel. Even a short opening merits evaluation if you can no longer bend or straighten normally, if sensitivity changes, or if depth is uncertain.
Loss of movement can also appear after closed trauma, without visible cuts. Do not test strength against resistance or try to simply reattach the skin to avoid an assessment. Cover a wound with a clean dressing and seek appropriate care. A tendon repair then requires a precise protocol: too much movement and too little can each pose a problem.
Chapter sources [3]
In everyday life
Before starting a hand exercise
Name the injury
Ask what structure is affected and if it has been repaired.
Clarify protection
Note which joints can move and which must remain stationary.
Follow the program
Use the prescribed exercises and contact the team if the function changes.
Chapter sources [3]
Signs that change urgency
A cold, pale or blue hand or finger, significant loss of sensation, difficult to control bleeding or a deep wound is an emergency. Deformation after an accident should not be put back into place by yourself. Call 112 if urgent help is needed in Luxembourg.
A human or animal bite to the hand requires prompt medical attention, even if the opening appears small. Widespread redness, warmth, pus, increasing pain, or fever requires same-day evaluation. Do not wait for the physiotherapy consultation and do not start a bath or massage as the only treatment.
Physiotherapy: follow the exact protocol
After certain injuries, hand rehabilitation helps control swelling, maintain movement in joints that are not immobilized and resume authorized movements. The clinician must know the injury, the date of the trauma, any operation and the instructions of the specialized team.
The exercises are specific: protecting the terminal extension in a mallet finger is not like mobilizing a repaired tendon or resuming pinch grips after ligament damage to the thumb. A squeeze ball, stretch, or downloaded exercise may be unsuitable at the wrong time. Ask for a demonstration, reproduce it and check the stopping criteria before practicing alone.
Hygiene, work and sport with an orthopaedic splint
An orthopaedic splint must protect the correct joint while respecting the skin. Ask how to clean it, when to remove it, and how to maintain the position if it needs to remain protected. Do not cut a device or change its angle without advice. Painful pressure or damaged skin requires adjustment.
At work, anticipate the risks of snagging, humidity or strong grip. For sport, the presence of an orthopaedic splint does not automatically mean that impacts are authorized. Driving and machines require a reliable and secure grip. The return should consider repair, function and safety regulations, not just comfort.
Recovery and reassessment
Swelling and stiffness may persist for several months after certain finger injuries. A small limitation may remain despite satisfactory function. The result depends on the injury, the alignment, the treatment time and compliance with appropriate protection.
Contact the team again if the orthopaedic splint no longer holds the position, if the finger folds during a protection phase, if the skin becomes damaged or if the pain increases. After a repair, a clicking sound followed by a loss of movement requires rapid advice. Monitoring is used to adjust the steps; you should not wait for the end of a generic timetable when faced with a significant change.
Your questions
Can I remove the mallet finger orthopaedic splint to do some movements?
Not during the period when the last joint must remain straight continuously. Even hygiene must respect the position shown by the team. Ask what other movements are allowed; a general finger program is not suitable for this protected joint.
Chapter sources [1]
How do I know if my thumb ligament is completely ruptured?
A medical examination is required, sometimes supplemented by imaging. Do not forcefully spread your thumb yourself to test its stability. Pain and swelling alone cannot distinguish a partial rupture from a complete or displaced rupture.
Chapter sources [2]
Can a small cut require specialized care?
Yes, if it affects a tendon, nerve, vessel or joint. A loss of movement or sensation is particularly significant. A bite to the hand also deserves prompt attention. The visible size of the wound is not enough to judge its depth.
Why not immediately strengthen the hand?
The injured structure may need very precise positioning and loading to heal. Forceful gripping can put tension on a repair or ligament. Strengthening comes at the authorized stage, after the movements and protection adapted to the injury.
Sources and references
- [1] BSSH: Mallet finger injury
- [2] BSSH: Skier’s thumb
- [3] BSSH: Extensor tendon injury
- [4] NHS: Broken arm or wrist
- [5] NHS: Animal and human bites
- [6] CGDIS · Appeler le 112
Text updated on
Medical review: awaiting Hasib Selimovic.