emergencynurse.co.uk | PEER-REVIEWED | evidence & practice / CPD / minor injuries Permission To reuse this article or for information about reprints and permissions, please contact permissions@rcni.com 36 / May 2020 / volume 28 number 3 Citation McGhee S, Gonzalez J, Nadeau C et al (2020) Mallet finger injuries: the signs, symptoms, diagnosis and management. Emergency Nurse. doi: 10.7748/en.2020.e1996 Peer review This article has been subject to external double-blind peer review and has been checked for plagiarism using automated software Correspondence stephenmcghee@miami.edu \@stephen37929091 Conflict of interest None declared Accepted 11 November 2019 Published online March 2020 Why you should read this article: ● To enhance your knowledge of the signs and symptoms of mallet finger injuries, including common presentations and the mechanism of injury ● To understand how to assess a patient with a suspected mallet finger injury, and the options for management ● To count towards revalidation as part of your 35 hours of continuing professional development, or you may wish to write a reflective account (UK readers) ● To contribute towards your professional development and local registration renewal requirements (non-UK readers) Mallet finger injuries: the signs, symptoms, diagnosis and management Stephen McGhee, Juan Gonzalez, Catherine Nadeau et al Abstract Patients commonly present to UK emergency departments with injuries to the tips of their fingers. Mallet finger is one of the most common injuries, resulting from an injury to the extensor tendon over the dorsal surface of the distal phalanges of the hand. Timely recognition, diagnosis and management are required to prevent complications. This article provides an overview of the pathophysiology, signs, symptoms, diagnosis and management of mallet finger injuries. Author details Stephen McGhee, associate dean for undergraduate programs/associate professor of clinical, School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States; Juan Gonzalez, assistant professor, School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States; Catherine Nadeau, clinical instructor, School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States; Johis Ortega, associate dean, global and hemispheric programs, School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, United States Keywords accident and emergency, acute pain, clinical skills, diagnosis, emergency care, minor injuries, nursing care, pain, X-rays Aims and intended learning outcomes The aim of this article is to develop emergency nurses’ knowledge of the pathophysiology, signs, symptoms, diagnosis and management of mallet finger injuries. After reading this article and completing the time out activities you should be able to: » Identify the incidence of hand injury presentations to emergency departments (EDs). » Outline the most common mechanisms of injury that result in mallet finger. » Discuss the main assessment criteria for the diagnosis of mallet finger injuries. » Describe the possible management options. » Identify the potential complications that can occur. Introduction In the UK, hand injuries represent 10% of all visits to EDs and up to 20% of all injuries treated (de Jong et al 2014). One of the most common presentations is mallet finger, which is a result of an injury to the extensor tendon over the dorsal surface of the distal phalanges of the hand (Ramponi and Hellier 2019). The anatomy of the fingers includes the interphalangeal joints. These are hinge joints known as the proximal interphalangeal joint (PIPJ) and the distal interphalangeal joint (DIPJ). The DIPJ is the location of a mallet finger deformity. The incidence of mallet finger was found to be 9.9/100,000 per year in one UK study (Clayton and Court-Brown 2008). The