Mallet Finger

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Mallet Finger

Authors, Editors, Case Information Author: Jaime Dougherty, BS Affiliation: Rowan-Viruta School of Osteopathic Medicine Co Author(s): Altamash Raja, DO, RMSK, CSCS Senior Editor: Laura Mattson, DO Senior Editor: Joshua Romero, MD Clinical Vignette: A 34-year-old male presented with 4 days of pain and swelling over the distal aspect of the 4th left digit following an injury during a flag football game. He endorsed the inability to extend his distal interphalangeal joint. Type of Probe Used: Linear transducer 15-4 MHz and 19-5 MHz Unlabeled Long Axis View of the Left 4th DIP Joint Unlabeled Long Axis View of the Left 4th DIP Joint Labeled Long Axis View of the Left 4th DIP Joint Labeled Long Axis View of athe Left 4th DIP Joint with the proximal portion of the distal phalanx at the distal interphalangeal joint avulsed off the base of the distal phalanx Unlabeled Long Axis View of the Left 4th DIP Joint with Doppler Unlabeled Long Axis View of the Left 4th DIP Joint with Doppler Labeled Long Axis View of the Left 4th DIP Joint with Doppler Labeled Long Axis View of the Left 4th DIP Joint with Doppler with the proximal portion of the distal phalanx at the distal interphalangeal joint avulsed off the base of the distal phalanx, and no significant hyperemia noted. Unlabeled Long Axis View of the Left 4th Distal Phalanx Avulsion Fracture Unlabeled Long Axis View of the Left 4th Distal Phalanx Avulsion Fracture with distance measurement Unlabeled Short Avis View of the Proximal Aspect of the Left 4th Distal Phalanx Unlabeled Short Avis View of the Proximal Aspect of the Left 4th Distal Phalanx Labeled Short Avis View of the Proximal Aspect of the Left 4th Distal Phalanx Labeled Short Avis View of the Proximal Aspect of the Left 4th Distal Phalanx with irrgularity of the bony contour consistent with a fracture #8 - Video View Video Unlabeled Long Axis Cine of the Left 4th DIP Joint from Medial to Lateral with evidence of avulsion fracture of the proximal aspect of the distal phalanx. #9 - Video View Video Unlabeled Short Axis Cine of the Left 4th DIP Joint from Proximal to Distal with evidence of avulsion fracture of the proximal aspect of the distal phalanx. Interpretation Image Interpretation: The proximal portion of the distal phalanx at the distal interphalangeal joint was avulsed off the base of the distal phalanx. The fragment was displaced 0.8 cm proximally with an intact extensor digitorum tendon attaching to the avulsed fragment. No hyperemia or soft tissue swelling was noted. No obvious disruption of the extensor tendon fibers. A 0.8 cm avulsion fracture at the 4th distal interphalangeal joint (Bony Mallet) Teaching Pearl: Ultrasound can be highly useful for small, superficial finger structures and can help distinguish purely tendinous mallet injury from bony mallet injury. It can show extensor tendon continuity, avulsion fragment size and degree of displacement, and dynamic tendon motion at the DIP joint. Ultrasound may reveal small bony fragments and tendon relationships that are not fully characterized by other imaging alone. Radiographs are still important for assessing joint alignment, fragment size, and volar subluxation. References: 1. Kleinbaum Y, Heyman Z, Ganel A, Blankstein A. Sonographic imaging of mallet finger. Ultraschall Med. 2005;26(3):223-226. doi:10.1055/s-2005-858165 2. Wang T, Qi H, Teng J, Wang Z, Zhao B. The role of high frequency ultrasonography in diagnosis of acute closed mallet finger injury. Sci Rep. 2017;7(1):11049. doi:10.1038/s41598-017-10959-x 3. Kim JY, Lee JB, Kim TH. Sonographic evaluation of tendinous mallet finger to estimate the extent of extension lag. Clin Orthop Surg. 2026;18(1):133-140. doi:10.4055/cios24511
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Authors, Editors, Case Information

Unlabeled Long Axis View of the Left 4th DIP Joint

Labeled Long Axis View of the Left 4th DIP Joint

Unlabeled Long Axis View of the Left 4th DIP Joint with Doppler

Labeled Long Axis View of the Left 4th DIP Joint with Doppler

Unlabeled Long Axis View of the Left 4th Distal Phalanx Avulsion Fracture

Unlabeled Short Avis View of the Proximal Aspect of the Left 4th Distal Phalanx

Labeled Short Avis View of the Proximal Aspect of the Left 4th Distal Phalanx

#8 - Video

#9 - Video

Interpretation

UPCOMING EVENTS

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