Painful Mallet Finger Tip after Trauma: A Case of Recurrent Symptoms Post Pull-through Reconstruction in A 68-Year-Old Woman

Abstract

Introduction: Mallet finger is a common hand injury caused by disruption of the terminal extensor tendon at the distal interphalangeal (DIP) joint. It is typically associated with sudden flexion of the extended fingertip. While conservative splinting is often effective, surgical management is required in cases with tendon retraction, large bony avulsions, chronic injuries, or recurrent symptoms. Case Presentation: Methods: A 68-year-old female presented to a hospital in Bali with painful fingertip contracture of the right ring finger following trauma. Four weeks prior, she had fallen and struck her fingertip against the floor. She reported persistent pain and functional limitation. Preoperative laboratory tests were within normal limits. Radiographic examination of the right hand revealed contracture at the DIP joint of the fourth digit without fracture or dislocation, accompanied by soft tissue swelling. Result: The patient underwent surgical pull-through reconstruction of the terminal extensor tendon. Postoperatively, she demonstrated a favourable recovery, with a significant reduction in pain, improvement in finger mobility, and no immediate complications. She was discharged after a 5-day hospital stay with instructions for hand therapy and follow-up evaluation. Discussion: It is important to consider surgical options in elderly patients with recurrent mallet finger symptoms, particularly when conservative management fails. Pull-through reconstruction remains an effective treatment for chronic or recurrent cases, restoring function and preventing long-term disability. Conclusion: Early recognition, proper surgical technique, and rehabilitation are essential to achieve optimal outcomes in this population.