This handout explains the follow-up care after the surgery to repair your mallet finger. The injury involves a rupture of the extensor tendon attachment to the bone, either with or without a small bone fragment. We used a pin that was inserted into the bone to make sure that the finger does not move and rupture the repair. Usually the pin is removed 8-10 weeks after the surgery. Once the pin sites have healed in 2-3 days, we will have our therapist make a smaller brace for you to wear that will be much more functional. At that point, the therapist will be able to instruct you on when you may get the finger wet for showering or bathing. Please see our pain management form for more detailed information regarding the management of your postoperative medications to avoid pain, nausea and constipation. If the incision is red or if there is drainage coming out of it, please call us right away at the phone number is listed at the bottom of the page. Go to the emergency room if this occurs at a night or on a weekend.

Wound Care:

  • After surgery, your hand will be placed in a bulky dressing (bandage) and a splint. The splint will help to protect the incision site and lessen the swelling.
  • Do not put any ointment or lotion on your wound.
  • For four days after surgery, cover your hand with a plastic bag when showering to keep it dry. After four days, you may shower without covering the incision, but do not soak your hand in the bathtub, hot tub, kitchen sink, swimming pool, etc.
  • Your hand and finger may swell. Use an ice pack for up to 20 minutes at a time (several times each day) over the surgery site to help ease the swelling. Make sure you place a thin cloth between your skin and the ice pack to protect your skin.
  • Elevate your hand as much as possible throughout the day, to lessen the swelling and pain.

Pain Management:

  • You will receive a prescription for narcotic pain medication. Take this with your medication, as directed. It is important to “stay ahead” of your pain medication and avoid having to play “catch up” for significant increases in pain. Medication for nausea will also be provided. Please make sure to take this as directed.
  • Please check with the postoperative nurses and the office staff at Bellevue Bone & Joint Physicians about how to manage your pain medication. To best manage your pain, you must take the pain medication the way it was prescribed. Taking the correct dose at the right time is very important.
  • If you have uncomfortable side effects from the pain medication, please call us at 425-462-9800.
  • Please see “medications after surgery” information form for more instructions.
  • It is normal to have some pain off and on for approximately one year after surgery, particularly in cold weather.

Driving:

  • Do not drive if you are taking narcotic medications, as it is not safe and against Washington state law. Taking medication can make you sleepy and delay your reaction time.
  • Once you are no longer taking narcotic medication, you may drive as soon as you can comfortably grip the steering wheel with both hands.

Activity:

  • You can use your hand for light activities such as driving, getting dressed, typing, etc.
  • You may do light aerobic activities as soon as one to two days after surgery.
  • Avoid heavy lifting such as weightlifting until 8-10 weeks after surgery with the operated hand when the pins have been removed.

Follow-Up:

  • You will have a follow-up appointment with a hand therapist 2-3 days after surgery. At this visit, your dressing will be removed and a small removable splint will be made for you.
  • When you leave the surgery center, you will have a follow-up appointment set for 10-14 days after surgery for your sutures removal in addition to the hand therapy appointment described above.
  • After your sutures are removed, you may increase your activities as tolerated, but avoid any heavy lifting or gripping activities with the operated hand until 8-10 weeks after surgery, when the pins have been removed.
  • During the surgery, small pins and/or screws are used to help stabilize the mallet finger injury. The pins can be removed with some minor surgery 8-10 weeks after your first surgery, either in the office or in the surgery center.

Results:

Most patients with mallet finger repair can regain full use of the hand with full return of motion and strength.


Thomas E. Trumble, M.D.

*Figures courtesy of Principles of Hand Surgery and Therapy by Thomas E. Trumble, MD, Ghazi M. Rayan, MD, Mark E. Baratz, MD and Jeffrey E. Budoff, MD