inability to extend the finger joint closest to the fingernail.There are a variety of causes of this condition such as arthritis, trauma etc.. Most commonly it is trauma & in this case scenario the treatment is straightforward. After the inciting trauma the extensor tendon crossing the last finger joint is ruptured. Since there is no longer any extensor pull to counteract the flexor tendon’s action the finger tip remains in a flexed position.
The good point about this injury is that the nature of finger anatomy is such that the ruptured ends do not retract-they remain in close proximity. Thus the problem can be effectively treated with an aluminum finger splint that prevents flexion of this last joint. The rupture endings are then kept close together & the rupture heals in about 6 weeks. After 6 weeks the splint is removed & if the problem hasn’t resolved it is placed back on for an additional 6 weeks. For the vast majority of patients this is sufficient. A minority require surgical reconstruction after this trial of splinting. It is important though to start the splinting right after the injury in order to get the best result. Some patients also require hand therapy to increase range of motion after the splinting period.
The exception to this treatment is the presence of a significant fracture in addition to the tendon rupture. That is why an x-ray should always be obtained & the treatment should be supervised by a qualified hand surgeon.