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Emergency Medicine3 papers

Closed fracture thumb distal phalanx, mallet

Last edited: 4/10/2026

Overview

Mallet thumb is an uncommon injury involving a closed rupture of the extensor pollicis longus tendon at its distal insertion 12. It must be distinguished from dropped thumb 2.

Diagnosis

  • Distinguish from dropped thumb 2.
  • Management

  • Conservative treatment can result in near-normal function 1.
  • Operative treatment is advised in some cases and has yielded excellent results in a small series 2.
  • Recommendations vary regarding operative versus conservative management 2.
  • Special Populations

  • No information provided.
  • Key Recommendations

  • Conservative treatment may result in near-normal function for mallet thumb 1. (Evidence: Weak)
  • Operative treatment is advised for mallet thumb, with excellent results reported in a small series 2. (Evidence: Weak)
  • Differential diagnosis should include dropped thumb 2. (Evidence: Expert opinion)
  • References

    1 De Smet L, Van Ransbeeck H. Mallet thumb. Acta orthopaedica Belgica 2003. link 2 Din KM, Meggitt BF. Mallet thumb. The Journal of bone and joint surgery. British volume 1983. link

    Original source

    1. [1]
      Mallet thumb.De Smet L, Van Ransbeeck H Acta orthopaedica Belgica (2003)
    2. [2]
      Mallet thumb.Din KM, Meggitt BF The Journal of bone and joint surgery. British volume (1983)

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