Skip to content

Patients › Hand

ਮੈਲੇਟ ਫਿੰਗਰ

Mallet finger causes fingertip drooping after extensor tendon injury; splinting is key, surgery occasionally needed.

Updated Aug 2026
ਇੱਕ ਹੱਥ ਦੀ ਹੱਥ ਨਾਲ ਬਣਾਈ ਗਈ ਚਿੱਤਰ, ਜਿਸਦੇ ਇੱਕ ਅੰਗੂਠੇ ਦਾ ਸਿਰਾ ਹੇਠਾਂ ਝੁਕਿਆ ਹੋਇਆ ਹੈ ਅਤੇ ਇਸਨੂੰ ਸਿੱਧਾ ਨਹੀਂ ਕੀਤਾ ਜਾ ਸਕਦਾ।
ਮੈਲੇਟ ਫਿੰਗਰ: ਉਂਗਲ ਦਾ ਸਿਰਾ ਝੁਕ ਜਾਂਦਾ ਹੈ ਕਿਉਂਕਿ ਆਖਰੀ ਜੋੜ ਨੂੰ ਸਿੱਧਾ ਕਰਨ ਵਾਲਾ ਐਕਸਟੈਂਸਰ ਟੈਂਡਨ ਫਟ ਜਾਂਦਾ ਹੈ ਜਾਂ ਆਪਣੇ ਜੁੜਾਅ ਤੋਂ ਖਿੱਚਿਆ ਜਾਂਦਾ ਹੈ। Holly Cheng / Wikimedia Commons, CC BY-SA 3.0

ਇਹ ਪੰਨਾ ਮਸ਼ੀਨ ਦੁਆਰਾ ਅਨੁਵਾਦ ਕੀਤਾ ਗਿਆ ਹੈ ਅਤੇ ਹਾਲੇ ਤੱਕ ਕਿਸੇ ਡਾਕਟਰ ਦੁਆਰਾ ਜਾਂਚਿਆ ਨਹੀਂ ਗਿਆ। ਅੰਗਰੇਜ਼ੀ ਸੰਸਕਰਣ ਹੀ ਅਧਿਕਾਰਤ ਹੈ।

ਤੁਸੀਂ ਕੀ ਮਹਿਸੂਸ ਕਰ ਰਹੇ ਹੋ

ਤੁਸੀਂ ਆਪਣੀ ਉਂਗਲ ਦੇ ਸਿਰੇ ਦਾ ਝੁਕਿਆ ਹੋਣਾ ਅਤੇ ਇਸਨੂੰ ਆਪਣੇ ਆਪ ਸਿੱਧਾ ਨਾ ਕਰ ਪਾਉਣਾ ਨੋਟ ਕਰ ਸਕਦੇ ਹੋ। ਇਹ ਉਦੋਂ ਹੁੰਦਾ ਹੈ ਜਦੋਂ ਤੁਹਾਡੀ ਉਂਗਲ ਨੂੰ ਉੱਚਾ ਉਠਾਉਣ ਵਾਲਾ ਟੈਂਡਨ ਖ਼ਰਾਬ ਹੋ ਜਾਂਦਾ ਹੈ। ਦਰਦ ਆਮ ਤੌਰ 'ਤੇ ਉਂਗਲ ਦੇ ਸਿਰੇ 'ਤੇ ਹੀ ਹੁੰਦਾ ਹੈ। ਜਦੋਂ ਤੁਸੀਂ ਇਸਨੂੰ ਹਿਲਾਉਣ ਜਾਂ ਉਸ ਖੇਤਰ 'ਤੇ ਦਬਾਅ ਪਾਉਣ ਦੀ ਕੋਸ਼ਿਸ਼ ਕਰਦੇ ਹੋ, ਤਾਂ ਇਹ ਤਿੱਖਾ ਮਹਿਸੂਸ ਹੋ ਸਕਦਾ ਹੈ।

ਅਸੁਵਿਧਾ ਅਕਸਰ ਤੁਸੀਂ ਆਪਣੇ ਹੱਥ ਦੀ ਵਰਤੋਂ ਕਰਨ ਤੋਂ ਬਾਅਦ ਵਧ ਜਾਂਦੀ ਹੈ। ਟਾਈਪਿੰਗ, ਸਾਮਾਨ ਚੁੱਕਣਾ ਜਾਂ ਖੇਡਾਂ ਖੇਡਣ ਵਰਗੀਆਂ ਗਤੀਵਿਧੀਆਂ ਨਾਲ ਇਸ ਵਿੱਚ ਵਧੇਰੇ ਦਰਦ ਹੋ ਸਕਦਾ ਹੈ। ਤੁਸੀਂ ਸਵੇਰ ਨੂੰ ਜਾਗਣ 'ਤੇ ਸਖ਼ਤੀ (stiffness) ਵੀ ਮਹਿਸੂਸ ਕਰ ਸਕਦੇ ਹੋ। ਇਹ ਸਖ਼ਤੀ ਆਮ ਤੌਰ 'ਤੇ ਕੁਝ ਮਿੰਟਾਂ ਲਈ ਹੱਥ ਚਲਾਉਣ ਤੋਂ ਬਾਅਦ ਘੱਟ ਜਾਂਦੀ ਹੈ।

ਰੋਜ਼ਾਨਾ ਦੀਆਂ ਗਤੀਵਿਧੀਆਂ ਮੁਸ਼ਕਲ ਹੋ ਜਾਂਦੀਆਂ ਹਨ। ਪਿੱਛੇ ਜਾ ਕੇ ਬ੍ਰਾ ਬੰਨ੍ਹਣਾ ਮੁਸ਼ਕਲ ਹੋ ਸਕਦਾ ਹੈ। ਸ਼ਰਟ ਨੂੰ ਅੰਦਰ ਛੁਪਾਉਣ ਲਈ ਉਂਗਲ ਨੂੰ ਝਟਕਾ ਲੱਗਣ ਤੋਂ ਬਚਾਉਣ ਲਈ ਸਾਵਧਾਨੀ ਨਾਲ ਕੋਆਰਡੀਨੇਸ਼ਨ ਦੀ ਲੋੜ ਹੁੰਦੀ ਹੈ। ਆਪਣੇ ਪਾਸੇ ਸੌਣ ਨਾਲ ਖ਼ਰਾਬ ਹੋਏ ਸਿਰੇ 'ਤੇ ਦਬਾਅ ਪੈ ਸਕਦਾ ਹੈ, ਜਿਸ ਕਾਰਨ ਦਰਦ ਹੋ ਸਕਦਾ ਹੈ ਜੋ ਤੁਹਾਨੂੰ ਜਾਗਦਾ ਰੱਖ ਸਕਦਾ ਹੈ।

ਕੁਝ ਮਾਮਲਿਆਂ ਵਿੱਚ, ਦੋਵਾਂ ਹੱਥਾਂ 'ਤੇ ਅਸਰ ਹੁੰਦਾ ਹੈ। ਇਹ ਉਦੋਂ ਹੋ ਸਕਦਾ ਹੈ ਜਦੋਂ ਤੁਹਾਡੇ ਸਰੀਰ ਵਿੱਚ ਕੁਝ ਜੈਵ-ਰਸਾਇਣਕ ਬਦਲਾਅ ਹੋਣ। ਜੇਕਰ ਤੁਸੀਂ ਬੱਚਾ ਹੋ, ਤਾਂ ਚੋਟ ਵਿੱਚ ਟੈਂਡਨ ਅਤੇ ਇੱਕ ਛੋਟੀ ਹੱਡੀ ਦੇ ਟੁਕੜੇ ਦੋਵਾਂ ਨਾਲ ਸੰਬੰਧਿਤ ਹੋ ਸਕਦਾ ਹੈ। ਇਹ ਘੱਟ ਹੁੰਦਾ ਹੈ ਪਰ ਸੰਭਵ ਹੈ।

ਜ਼ਿਆਦਾਤਰ ਸਮੇਂ, ਅਸੀਂ ਇਸਦਾ ਇਲਾਜ ਸਪਲਿੰਟ ਨਾਲ ਕਰਦੇ ਹਾਂ। ਅਸੀਂ ਤੁਹਾਡੀ ਉਂਗਲ ਦੇ ਪਿੱਛੇ ਇੱਕ ਸਧਾਰਨ ਸਹਾਇਕ ਫ਼ਰੀਸ਼ (support) ਚਿਪਕਾਉਂਦੇ ਹਾਂ। ਇਹ ਸਿਰੇ ਨੂੰ ਸਿੱਧਾ ਰੱਖਦਾ ਹੈ ਤਾਂ ਜੋ ਟੈਂਡਨ ਠੀਕ ਹੋ ਸਕੇ। ਤੁਸੀਂ ਇਸਨੂੰ ਕਈ ਹਫ਼ਤਿਆਂ ਲਈ ਲਗਾਤਾਰ ਪਾਉਂਦੇ ਹੋ। ਸਰਜਰੀ ਦੀ ਲੋੜ ਤਦ ਹੀ ਪੈਂਦੀ ਹੈ ਜੇਕਰ ਹੱਡੀ ਦਾ ਵੱਡਾ ਟੁਕੜਾ ਟੁੱਟ ਜਾਵੇ ਜਾਂ ਹੱਡੀ ਆਪਣੀ ਥਾਂ ਤੋਂ ਖਿਸਕ ਜਾਵੇ।

ਸਪਲਿੰਟਿੰਗ ਅਤੇ ਸਰਜਰੀ ਦੋਵਾਂ ਨਾਲ ਚੰਗੇ ਨਤੀਜੇ ਮਿਲਦੇ ਹਨ। ਤੁਹਾਨੂੰ ਕੁਝ ਲੰਬੇ ਸਮੇਂ ਤੱਕ ਰਹਿਣ ਵਾਲੀ ਸਖ਼ਤੀ ਦੀ ਉਮੀਦ ਰੱਖਣੀ ਚਾਹੀਦੀ ਹੈ, ਖ਼ਾਸ ਕਰਕੇ ਜੇਕਰ ਇਲਾਜ ਤੋਂ ਪਹਿਲਾਂ ਝੁਕਾਅ ਗੰਭੀਰ ਸੀ। ਪੂਰਾ ਸੁਧਾਰ ਸਮਾਂ ਲੈਂਦਾ ਹੈ। ਆਪਣੀ ਠੀਕ ਹੋਣ ਦੀ ਪ੍ਰਕਿਰਿਆ ਵਿੱਚ ਧੀਰਜ ਰੱਖੋ। ਤੁਹਾਡਾ ਸਰਜਨ ਤੁਹਾਨੂੰ ਪੂਰੀ ਪ੍ਰਕਿਰਿਆ ਦੌਰਾਨ ਮਾਰਗਦਰਸ਼ਨ ਕਰੇਗਾ।

ਅਸਲ ਵਿੱਚ ਕੀ ਹੋ ਰਿਹਾ ਹੈ

ਤੁਹਾਡੀ ਉਂਗਲ ਦੇ ਸਿਰੇ 'ਤੇ ਟਰਮੀਨਲ ਟੈਂਡਨ (terminal tendon) ਨਾਮਕ ਇੱਕ ਛੋਟਾ ਟੈਂਡਨ ਹੁੰਦਾ ਹੈ। ਇਹ ਤੁਹਾਡੀ ਉਂਗਲ ਦੇ ਸਭ ਤੋਂ ਅੰਤਿਮ ਹੱਡੀ ਨਾਲ ਜੁੜਿਆ ਹੁੰਦਾ ਹੈ। ਇਹ ਟੈਂਡਨ ਇੱਕ ਰੱਸੀ ਵਾਂਗ ਕੰਮ ਕਰਦਾ ਹੈ ਜੋ ਤੁਹਾਡੀ ਉਂਗਲ ਦੇ ਸਿਰੇ ਨੂੰ ਸਿੱਧਾ ਕਰਦਾ ਹੈ। ਜਦੋਂ ਤੁਸੀਂ ਆਪਣੀ ਉਂਗਲ ਨੂੰ ਸਿੱਧਾ ਕਰਦੇ ਹੋ, ਤਾਂ ਇਹ ਰੱਸੀ ਸਿਰੇ ਨੂੰ ਉੱਪਰ ਉਠਾਉਣ ਲਈ ਖਿੱਚੀ ਜਾਂਦੀ ਹੈ।

ਮੈਲੇਟ ਫਿੰਗਰ (mallet finger) ਦੀ ਚੋਟ ਵਿੱਚ, ਇਹ ਰੱਸੀ ਟੁੱਟ ਜਾਂਦੀ ਹੈ ਜਾਂ ਹੱਡੀ ਤੋਂ ਖਿੱਚੀ ਜਾਂਦੀ ਹੈ। ਇਹ ਆਮ ਤੌਰ 'ਤੇ ਤਦ ਹੁੰਦਾ ਹੈ ਜਦੋਂ ਤੁਹਾਡੀ ਸਿੱਧੀ ਉਂਗਲ ਦਾ ਸਿਰਾ ਅਚਾਨਕ ਅੰਦਰ ਵੱਲ ਮੁੜ ਜਾਂਦਾ ਹੈ। ਕੋਈ ਚੀਜ਼ ਲੈਣ ਲਈ ਪਹੁੰਚਦੇ ਸਮੇਂ ਆਪਣੀ ਉਂਗਲ ਨੂੰ ਮੇਜ਼ ਦੇ ਕਿਨਾਰੇ 'ਤੇ ਫਸਾਉਣ ਬਾਰੇ ਸੋਚੋ। ਟੈਂਡਨ ਨੂੰ ਸਹਿਣ ਲਈ ਬਲ ਬਹੁਤ ਜ਼ਿਆਦਾ ਹੁੰਦਾ ਹੈ।

ਕਿਉਂਕਿ ਰੱਸੀ ਟੁੱਟ ਜਾਂਦੀ ਹੈ, ਤੁਸੀਂ ਆਪਣੇ ਆਪ ਆਪਣੀ ਉਂਗਲ ਦੇ ਸਿਰੇ ਨੂੰ ਸਿੱਧਾ ਨਹੀਂ ਕਰ ਸਕਦੇ। ਜੋੜ ਮੁੜੇ ਹੋਏ ਸਥਿਤੀ ਵਿੱਚ ਰਹਿੰਦਾ ਹੈ। ਇਸਨੂੰ ਮੈਲੇਟ ਡਿਫਾਰਮਿਟੀ (mallet deformity) ਕਿਹਾ ਜਾਂਦਾ ਹੈ। ਤੁਸੀਂ ਸਿਰੇ ਦੇ ਹੇਠਾਂ ਝੁਕੇ ਹੋਣ ਨੂੰ ਦੇਖ ਸਕਦੇ ਹੋ। ਹਾਲਾਂਕਿ, ਜੇ ਕੋਈ ਹੋਰ ਤੁਹਾਡੀ ਉਂਗਲ ਨੂੰ ਹਿਲਾਉਂਦਾ ਹੈ, ਤਾਂ ਤੁਸੀਂ ਇਸਨੂੰ ਪੂਰੀ ਤਰ੍ਹਾਂ ਸਿੱਧਾ ਕਰ ਸਕਦੇ ਹੋ। ਇਹ ਇਸ ਲਈ ਹੈ ਕਿਉਂਕਿ ਪੈਸਿਵ ਰੇਂਜ ਆਫ਼ ਮੋਸ਼ਨ (passive range of motion) ਬਰਕਰਾਰ ਰਹਿੰਦੀ ਹੈ।

ਚੋਟ ਦੋ ਤਰੀਕਿਆਂ ਨਾਲ ਹੋ ਸਕਦੀ ਹੈ। ਪਹਿਲਾਂ, ਟੈਂਡਨ ਖੁਦ ਪੂਰੀ ਤਰ੍ਹਾਂ ਫਟ ਸਕਦਾ ਹੈ। ਦੂਜਾ, ਹੱਡੀ ਦਾ ਇੱਕ ਛੋਟਾ ਟੁਕੜਾ ਟੈਂਡਨ ਨਾਲ ਖਿੱਚਿਆ ਜਾ ਸਕਦਾ ਹੈ। ਇਸਨੂੰ ਅਵਲਸ਼ਨ ਫ੍ਰੈਕਚਰ (avulsion fracture) ਕਿਹਾ ਜਾਂਦਾ ਹੈ। ਹੱਡੀ ਦਾ ਟੁਕੜਾ ਟੈਂਡਨ ਦੇ ਜੁੜਨ ਵਾਲੇ ਹਿੱਸੇ ਨੂੰ ਸ਼ਾਮਲ ਕਰਦਾ ਹੈ, ਇਸਲਈ ਨਤੀਜਾ ਸਮਾਨ ਦਿਖਾਈ ਦਿੰਦਾ ਹੈ। ਦੋਵੇਂ ਕਿਸਮਾਂ ਦਾ ਇੱਕੋ ਜਿਹਾ ਝੁਕਿਆ ਹੋਇਆ ਸਥਿਤੀ ਦਾ ਕਾਰਨ ਬਣਦਾ ਹੈ।

ਕਈ ਵਾਰ, ਹੱਡੀ ਦਾ ਇੱਕ ਵੱਡਾ ਟੁਕੜਾ ਟੁੱਟ ਜਾਂਦਾ ਹੈ। ਇਸ ਵਿੱਚ ਜੋੜ ਦੀ ਸਤਹ ਦਾ ਇੱਕ-ਤਿਹਾਈ ਤੋਂ ਵੱਧ ਹਿੱਸਾ ਸ਼ਾਮਲ ਹੁੰਦਾ ਹੈ। ਇਸ ਸਥਿਤੀ ਵਿੱਚ, ਅੰਤਿਮ ਹੱਡੀ ਸੰਰੇਖਣ ਤੋਂ ਬਾਹਰ ਅੱਗੇ ਖਿਸਕ ਸਕਦੀ ਹੈ। ਇਸਨੂੰ ਵੋਲਰ ਸਬਲਕਸੇਸ਼ਨ (volar subluxation) ਕਿਹਾ ਜਾਂਦਾ ਹੈ। ਇਹ ਜੋੜ ਦੇ ਕੰਮ ਕਰਨ ਦੇ ਤਰੀਕੇ ਨੂੰ ਬਦਲ ਦਿੰਦਾ ਹੈ ਅਤੇ ਅਕਸਰ ਵੱਖਰੇ ਇਲਾਜ ਦੀ ਲੋੜ ਹੁੰਦੀ ਹੈ।

ਬੱਚਿਆਂ ਵਿੱਚ, ਚੋਟ ਟੈਂਡਨ ਦੀ ਬਜਾਏ ਗਰੋਥ ਪਲੇਟ (growth plate) ਨੂੰ ਪ੍ਰਭਾਵਿਤ ਕਰ ਸਕਦੀ ਹੈ। ਉੱਥੇ ਹੱਡੀ ਨਰਮ ਹੁੰਦੀ ਹੈ। ਫ੍ਰੈਕਚਰ ਉਂਗਲ ਦੇ ਸਿਰੇ ਨੂੰ ਮੈਲੇਟ ਸਥਿਤੀ ਵਿੱਚ ਵਿਸਥਾਪਿਤ ਕਰ ਸਕਦਾ ਹੈ। ਹਾਈਪਰਐਕਸਟੈਂਸ਼ਨ (hyperextension) ਇਸਨੂੰ ਆਪਣੀ ਥਾਂ 'ਤੇ ਵਾਪਸ ਲਿਆਉਣ ਵਿੱਚ ਆਮ ਤੌਰ 'ਤੇ ਮਦਦ ਕਰਦੀ ਹੈ।

ਜ਼ਿਆਦਾਤਰ ਮੈਲੇਟ ਫਿੰਗਰ ਬੰਦ ਚੋਟਾਂ (closed injuries) ਕਾਰਨ ਹੁੰਦੇ ਹਨ। ਚਮੜੀ ਸਲੀਮਾ ਰਹਿੰਦੀ ਹੈ। ਉਹਨਾਂ ਚੋਟਾਂ ਜਿੱਥੇ ਚਮੜੀ ਫਟਦੀ ਹੈ, ਉਹ ਆਮ ਨਹੀਂ ਹਨ। ਛੋਟੀ, ਅੰਗੂਠੇ ਅਤੇ ਵਿਚਕਾਰਲੀ ਉਂਗਲ ਸਭ ਤੋਂ ਵੱਧ ਪ੍ਰਭਾਵਿਤ ਹੁੰਦੀਆਂ ਹਨ। ਇਹ ਮਰਦਾਂ ਵਿੱਚ ਆਮ ਹੈ।

ਇਸ ਬਾਰੇ ਅਸੀਂ ਕੀ ਕਰ ਸਕਦੇ ਹਾਂ

ਮੈਟਰ ਪ੍ਰਾਈਵੇਟ ਹਸਪਤਾਲ ਰੌਕਹੈਮਪਟਨ ਵਿੱਚ ਇੱਕ ਅਪਰ-ਲਿੰਬ ਸਰਜਨ ਡਾ. ਕਿਰਨ ਹਿਰਪਾਰਾ ਦੁਆਰਾ ਕਲੀਨਿਕ ਵਿੱਚ ਇਸਦੇ ਨਾਲ ਕਿਵੇਂ ਪ੍ਰਵਾਹਿਤ ਕੀਤਾ ਜਾਂਦਾ ਹੈ, ਇਹ ਇੱਕ ਸਪੱਸ਼ਟ ਰਸਤਾ ਦਰਸਾਉਂਦਾ ਹੈ। ਮਰੀਜ਼ ਜਨਰਲ ਪ੍ਰੈਕਟੀਸ਼ਨਰ (GP) ਜਾਂ ਭੌਤਿਕ ਚਿਕਿਤਸਕ (physiotherapist) ਦੇ ਹਵਾਲੇ ਦੁਆਰਾ ਸਾਡੀ ਕਲੀਨਿਕ ਵਿੱਚ ਪਹੁੰਚਦੇ ਹਨ। ਇੱਕ ਕਲੀਨਿਕ ਮੁਲਾਂਕਣ (ਇਤਿਹਾਸ, ਜਾਂਚ, ਅਤੇ ਜਿੱਥੇ ਲੋੜੀਂਦਾ ਹੋਵੇ ਤਾਂ ਇਮੇਜਿੰਗ) ਨਿਦਾਨ ਨੂੰ ਸਥਾਪਿਤ ਕਰਦਾ ਹੈ। ਬਣਾਵਟੀ ਜਾਂ ਤਾਜ਼ਾ ਸਮੱਸਿਆਵਾਂ ਲਈ, ਸਰਜਰੀ ਦੀ ਸਿਫਾਰਸ਼ ਤੁਰੰਤ ਕੀਤੀ ਜਾ ਸਕਦੀ ਹੈ, ਬਿਨਾਂ ਕਿਸੇ ਪਹਿਲਾਂ ਦੇ ਗੈਰ-ਸਰਜਰੀ ਪਰੀਖਣ ਦੇ। ਖਰਾਬ ਹੋਣ ਵਾਲੀਆਂ ਜਾਂ ਲੰਬੇ ਸਮੇਂ ਤੋਂ ਚੱਲ ਰਹੀਆਂ ਸਮੱਸਿਆਵਾਂ ਲਈ ਅਸੀਂ ਆਮ ਤੌਰ 'ਤੇ ਗੈਰ-ਸਰਜਰੀ ਦੇਖਭਾਲ ਦੀ ਕੋਸ਼ਿਸ਼ ਕਰਦੇ ਹਾਂ — ਗਤੀਵਿਧੀ ਬਦਲਣਾ, ਭੌਤਿਕ ਚਿਕਿਤਸਾ ਜਾਂ ਹੱਥ ਦੀ ਥੈਰੇਪੀ, ਸਪਲਿੰਟਿੰਗ, ਅਤੇ ਇੰਜੈਕਸ਼ਨ — ਅਤੇ ਜਦੋਂ ਇਸਨੇ ਪਰਿਪੱਕ ਸੁਧਾਰ ਨਹੀਂ ਦਿੱਤਾ ਹੁੰਦਾ ਤਾਂ ਸਰਜਰੀ 'ਤੇ ਵਿਚਾਰ ਕੀਤਾ ਜਾਂਦਾ ਹੈ।

ਜ਼ਿਆਦਾਤਰ ਮੈਲੇਟ ਫਿੰਗਰ ਚੋਟਾਂ ਸਰਜਰੀ ਬਿਨਾਂ ਚੰਗੀ ਤਰ੍ਹਾਂ ਭਰ ਜਾਂਦੀਆਂ ਹਨ। ਅਸੀਂ ਅਕਸਰ ਇੱਕ ਡੋਰਸਲ ਗਲੂਡ ਸਪਲਿੰਟ ਜਾਂ ਇੱਕ ਸਧਾਰਨ ਸਪਲਿੰਟ ਨਾਲ ਸ਼ੁਰੂਆਤ ਕਰਦੇ ਹਾਂ। ਤੁਸੀਂ ਇਸਨੂੰ ਤੁਹਾਡੇ ਉਂਗਲ ਦੇ ਸਿਰੇ ਨੂੰ ਸਿੱਧਾ ਰੱਖਣ ਲਈ ਪਾਉਂਦੇ ਹੋ। ਇੱਕ ਹੱਥ ਦੀ ਥੈਰੇਪਿਸਟ ਟਾਈਪ 1 ਮੈਲੇਟ ਫਿੰਗਰ ਚੋਟਾਂ ਦੀ ਇੰਨੀ ਹੀ ਪ੍ਰਭਾਵਸ਼ਾਲੀ ਤਰ੍ਹਾਂ ਦੇਖਭਾਲ ਕਰ ਸਕਦੀ ਹੈ ਜਿੰਨੀ ਕਿ ਇੱਕ ਸਰਜਨ। ਉਹ ਇੱਕ ਅਭਿਨਿਰਤਾ (immobilisation) ਦੀ ਵਿਧੀ ਦੀ ਵਰਤੋਂ ਕਰਦੇ ਹਨ ਜੋ ਚਮੜੀ ਦੀ ਸਥਿਤੀ ਬਾਰੇ ਵਿਹਲੇ ਤੌਰ 'ਤੇ ਕੋਈ ਜਟਿਲਤਾਵਾਂ ਪੇਸ਼ ਨਹੀਂ ਕਰਦੀ। ਪੂਰਕ ਰਾਤ ਦੀ ਸਪਲਿੰਟਿੰਗ ਵਿਸਤਾਰ ਲੈਗ (extensor lag), ਅਸਮਰੱਥਾ, ਜਾਂ ਇਲਾਜ ਨਾਲ ਸੰਤੁਸ਼ਟੀ ਦੇ ਸੰਦਰਭ ਵਿੱਚ ਨਤੀਜੇ ਨੂੰ ਬਿਹਤਰ ਨਹੀਂ ਬਣਾਉਂਦੀ। ਕੁਝ ਮਰੀਜ਼ ਇੱਕ ਵਿਕਲਪਿਕ ਸਧਾਰਨ ਅਤੇ ਕਸਟਮ-ਬਣਾਈ ਗਈ ਓਰਥੋਸਿਸ ਦੀ ਵਰਤੋਂ ਕਰਦੇ ਹਨ। ਇਹ PIP ਫਲੈਕਸ਼ਨ ਦੀ ਆਗਿਆ ਦਿੰਦਾ ਹੈ ਜਦੋਂ ਕਿ ਪੂਰਨ ਵਿਸਤਾਰ ਜਾਂ ਹਾਈਪਰਐਕਸਟੈਂਸ਼ਨ ਨੂੰ ਰੋਕਦਾ ਹੈ। ਤਾਜ਼ਾ, ਬੰਦ ਮੈਲੇਟ ਫਿੰਗਰ ਦੀ ਸੰਭਾਲ ਥੈਰੇਪਿਊਟਿਕ ਪ੍ਰਬੰਧਨ ਵਿਭਿੰਨ ਅਤੇ ਵੱਖਰਾ ਹੈ, ਜਿਸ ਵਿੱਚ ਸਪਲਿੰਟਿੰਗ ਦੇ ਪੂਰਕ ਵਜੋਂ ਅਭਿਆਸ ਅਤੇ ਦਖਲਅੰਦਾਜ਼ੀਆਂ ਆਮ ਤੌਰ 'ਤੇ ਵਰਤੀਆਂ ਜਾਂਦੀਆਂ ਹਨ।

ਸਰਜਰੀ ਦੀ ਕਦੇ-ਕਦਾਈਂ ਤਾਜ਼ਾ ਜਾਂ ਕ੍ਰੋਨਿਕ ਮੈਲੇਟ ਮਾਮਲਿਆਂ ਲਈ ਜਾਂ ਅਸਫਲ ਪਹਿਲਾਂ ਦੇ ਇਲਾਜ ਦੀ ਸੁਧਾਰ ਲਈ ਸਿਫਾਰਸ਼ ਕੀਤੀ ਜਾਂਦੀ ਹੈ। ਅਸੀਂ ਗੈਰ-ਸਰਜਰੀ ਇਲਾਜ ਵਿੱਚ ਅਸਫਲ ਰਹੇ ਮਰੀਜ਼ਾਂ ਵਿੱਚ ਤਾਜ਼ਾ ਅਤੇ ਕ੍ਰੋਨਿਕ ਮੈਲੇਟ ਘਾਵਾਂ ਲਈ ਸਰਜਰੀ ਪ੍ਰਬੰਧਨ 'ਤੇ ਵਿਚਾਰ ਕਰ ਸਕਦੇ ਹਾਂ। ਅਸੀਂ ਉਹਨਾਂ ਮਰੀਜ਼ਾਂ ਲਈ ਵੀ ਇਸ 'ਤੇ ਵਿਚਾਰ ਕਰਦੇ ਹਾਂ ਜੋ ਸਪਲਿੰਟ ਸਥਿਤੀ ਵਿੱਚ ਹੋਣ ਕਾਰਨ ਕੰਮ ਨਹੀਂ ਕਰ ਸਕਦੇ। ਸਰਜਰੀ ਆਮ ਤੌਰ 'ਤੇ ਉਹਨਾਂ ਮੈਲੇਟ ਫ੍ਰੈਕਚਰਾਂ ਦੇ ਮਾਮਲੇ ਵਿੱਚ ਸੰਕੇਤਿਤ ਹੁੰਦੀ ਹੈ ਜਿਨ੍ਹਾਂ ਵਿੱਚ ਕਲਾਪਿਕ ਸਤਹ ਦਾ ਇੱਕ-ਤਿਹਾਈ ਤੋਂ ਵੱਧ ਹਿੱਸਾ ਸ਼ਾਮਲ ਹੁੰਦਾ ਹੈ। ਇਹ ਉਹਨਾਂ ਸਾਰੇ ਮਰੀਜ਼ਾਂ ਵਿੱਚ ਵੀ ਸੰਕੇਤਿਤ ਹੁੰਦਾ ਹੈ ਜਿਨ੍ਹਾਂ ਵਿੱਚ ਦੂਜੇ ਫਲੈਂਕਸ ਦੇ ਵੋਲਰ ਸਬਲਕਸੇਸ਼ਨ (volar subluxation) ਦਾ ਵਿਕਾਸ ਹੁੰਦਾ ਹੈ। ਹਾਲਾਂਕਿ, ਜਟਿਲ ਮਾਮਲਿਆਂ ਵਿੱਚ ਸਰਜਰੀ ਪ੍ਰਬੰਧਨ ਦਾ ਇੱਕ ਮਹੱਤਵਪੂਰਨ ਫਾਇਦਾ ਅਜੇ ਤੱਕ ਸਪੱਸ਼ਟ ਤੌਰ 'ਤੇ ਸਾਬਤ ਨਹੀਂ ਹੋਇਆ ਹੈ। ਡੋਇਲ ਟਾਈਪ 4c ਮੈਲੇਟ ਫਿੰਗਰ ਦੀ ਸੰਭਾਲ ਦੇ ਨਤੀਜੇ ਦੀ ਦਰਾਂ ਘੱਟ ਹਨ, ਜੋ ਸੁਝਾਅ ਦਿੰਦੀਆਂ ਹਨ ਕਿ ਵੱਡੇ-ਖੰਡ ਵਾਲੇ ਮਾਮਲਿਆਂ ਨੂੰ ਪ੍ਰਭਾਵਸ਼ਾਲੀ ਤਰ੍ਹਾਂ ਸੰਭਾਲ ਨਾਲ ਪ੍ਰਬੰਧਿਤ ਕੀਤਾ ਜਾ ਸਕਦਾ ਹੈ।

ਤੁਹਾਡੀ ਉਮੀਦ ਕੀ ਹੋ ਸਕਦੀ ਹੈ

ਜ਼ਿਆਦਾਤਰ ਮੈਲੇਟ ਫਿੰਗਰ (mallet finger) ਦੀਆਂ ਚੋਟਾਂ ਬਿਨਾਂ ਸਰਜਰੀ ਦੇ ਠੀਕ ਹੋ ਜਾਂਦੀਆਂ ਹਨ। ਤੁਸੀਂ ਸ਼ਾਇਦ ਤੁਹਾਡੀ ਉਂਗਲ ਦੇ ਸਿਰੇ ਨੂੰ ਸਿੱਧਾ ਰੱਖਣ ਲਈ ਇੱਕ ਸਪਲਿੰਟ ਪਾਉਣਗੇ। ਇਹ ਟੈਂਡਨ ਜਾਂ ਹੱਡੀ ਨੂੰ ਸਹੀ ਸਥਿਤੀ ਵਿੱਚ ਠੀਕ ਹੋਣ ਦਿੰਦਾ ਹੈ। ਸਪਲਿੰਟਿੰਗ ਅਤੇ ਸਰਜਰੀ ਦੋਵਾਂ ਨਾਲ ਮਰੀਜ਼ਾਂ ਦੀ ਵੱਡੀ ਗਿਣਤੀ ਲਈ ਕਲੀਨਿਕਲ ਨਤੀਜੇ ਵਧੀਆ ਹੁੰਦੇ ਹਨ।

ਜੇਕਰ ਤੁਹਾਡੀ ਚੋਟ ਵਿੱਚ ਹੱਡੀ ਦਾ ਵੱਡਾ ਟੁਕੜਾ ਸ਼ਾਮਲ ਹੈ ਜਾਂ ਜੋੜ ਆਪਣੀ ਥਾਂ ਤੋਂ ਖਿਸਕ ਗਿਆ ਹੈ, ਤਾਂ ਤੁਹਾਡਾ ਸਰਜਨ ਸਰਜਰੀ ਦੀ ਸਿਫਾਰਸ਼ ਕਰ ਸਕਦਾ ਹੈ। ਇਹ ਅਕਸਰ ਜੋੜ ਨੂੰ ਸਥਿਰ ਕਰਨ ਅਤੇ ਲੰਬੇ ਸਮੇਂ ਦੇ ਵਿਗਾੜ ਨੂੰ ਰੋਕਣ ਲਈ ਕੀਤੀ ਜਾਂਦੀ ਹੈ। ਇਹਨਾਂ ਵਧੇਰੇ ਜਟਿਲ ਮਾਮਲਿਆਂ ਵਿੱਚ ਵੀ, ਨਤੀਜੇ ਆਮ ਤੌਰ 'ਤੇ ਬਹੁਤ ਵਧੀਆ ਹੁੰਦੇ ਹਨ।

ਤੁਹਾਨੂੰ ਉਮੀਦ ਕਰਨੀ ਚਾਹੀਦੀ ਹੈ ਕਿ ਰਿਕਵਰੀ ਦੀ ਪ੍ਰਕਿਰਿਆ ਵਿੱਚ ਕਈ ਮਹੀਨੇ ਲੱਗਣਗੇ। ਨਿਰੰਤਰਤਾ ਮੁੱਖ ਕੁੰਜੀ ਹੈ। ਤੁਹਾਨੂੰ ਤੁਹਾਡੇ ਸਰਜਨ ਦੁਆਰਾ ਸਲਾਹ ਦਿੱਤੇ ਗਏ ਸਮੇਂ ਦੌਰਾਨ ਸਪਲਿੰਟ ਨੂੰ ਲਗਾਤਾਰ ਪਾਈ ਰੱਖਣੀ ਚਾਹੀਦੀ ਹੈ। ਇਸਨੂੰ ਜਲਦੀ ਹਟਾਉਣ ਨਾਲ ਚੋਟ ਦੁਬਾਰਾ ਖੁੱਲ੍ਹ ਸਕਦੀ ਹੈ ਜਾਂ ਠੀਕ ਨਹੀਂ ਹੋ ਸਕਦੀ। ਇੱਕ ਵਾਰ ਠੀਕ ਹੋਣਾ ਪੂਰਾ ਹੋ ਜਾਣ 'ਤੇ, ਤੁਸੀਂ ਧੀਰਜ ਨਾਲ ਗਤੀਸ਼ੀਲਤਾ ਅਤੇ ਤਾਕਤ ਵਾਪਸ ਪ੍ਰਾਪਤ ਕਰੋਗੇ।

ਕੁਝ ਮਰੀਜ਼ਾਂ ਨੂੰ ਸਖ਼ਤੀ ਦੀ ਥੋੜ੍ਹੀ ਮਾਤਰਾ ਜਾਂ ਉਂਗਲ ਦੇ ਸਿਰੇ ਵਿੱਚ ਇੱਕ ਹਲਕਾ ਮੁੜਨਾ ਨਜ਼ਰ ਆ ਸਕਦਾ ਹੈ ਜੋ ਪੂਰੀ ਤਰ੍ਹਾਂ ਸਿੱਧਾ ਨਹੀਂ ਹੁੰਦਾ। ਇਸਨੂੰ ਐਕਸਟੈਂਸਰ ਲੈਗ (extensor lag) ਕਿਹਾ ਜਾਂਦਾ ਹੈ। ਇਹ ਵਧੇਰੇ ਆਮ ਹੈ ਜੇਕਰ ਚੋਟ ਗੰਭੀਰ ਸੀ ਜਾਂ ਇਲਾਜ ਵਿੱਚ ਦੇਰੀ ਹੋਈ ਸੀ। ਹਾਲਾਂਕਿ, ਇਹ ਛੋਟੀ ਸੀਮਾ ਤੁਹਾਡੀ ਰੋਜ਼ਾਨਾ ਕੰਮਾਂ ਲਈ ਹੱਥ ਦੀ ਵਰਤੋਂ ਦੀ ਸਮਰੱਥਾ ਨੂੰ ਪ੍ਰਭਾਵਿਤ ਕਰਨ ਦੀ ਬਹੁਤ ਘੱਟ ਸੰਭਾਵਨਾ ਹੈ।

ਜਟਿਲਤਾਵਾਂ ਆਮ ਨਹੀਂ ਹਨ। ਸੰਕਰਮਣ, ਗੈਰ-ਯੂਨੀਅਨ (ਜਿੱਥੇ ਹੱਡੀ ਠੀਕ ਨਹੀਂ ਹੁੰਦੀ), ਜਾਂ ਨੱਖ ਦੇ ਵਿਗਾੜ ਆਮ ਨਹੀਂ ਹੁੰਦੇ ਜੇਕਰ ਚੋਟ ਦੀ ਢੁਕਵੀਂ ਦੇਖਭਾਲ ਕੀਤੀ ਜਾਂਦੀ ਹੈ। ਜੇਕਰ ਤੁਹਾਡੇ ਕੋਲ ਜੋੜ ਦੀ ਸਤਹ ਦੇ ਵੱਡੇ ਹਿੱਸੇ ਨਾਲ ਸੰਬੰਧਿਤ ਫ੍ਰੈਕਚਰ ਹੈ, ਤਾਂ ਇਸਦੀ ਸੰਭਾਵਨਾ ਹੈ ਕਿ ਜੋੜ ਖਿਸਕ ਸਕਦਾ ਹੈ। ਤੁਹਾਡਾ ਸਰਜਨ ਸਹੀ ਸੰਰੇਖਣ ਨੂੰ ਯਕੀਨੀ ਬਣਾਉਣ ਲਈ ਇਸਦਾ ਨੇੜਿਓਂ ਨਿਰੀਖਣ ਕਰੇਗਾ।

ਨਾਜ਼ੁਕ ਮਾਮਲਿਆਂ ਵਿੱਚ ਜਿੱਥੇ ਸ਼ੁਰੂਆਤੀ ਇਲਾਜ ਅਸਫਲ ਰਹਿੰਦਾ ਹੈ, ਵਿਗਾੜ ਨੂੰ ਸੁਧਾਰਨ ਲਈ ਹੋਰ ਸਰਜਰੀ ਦੀ ਲੋੜ ਹੋ ਸਕਦੀ ਹੈ। ਇਹ ਸੈਲਵੇਜ ਪ੍ਰੋਸੀਜਰ (salvage procedures) ਕਾਰਜਸ਼ੀਲਤਾ ਅਤੇ ਦਿੱਖ ਨੂੰ ਬਹਾਲ ਕਰਨ ਵਿੱਚ ਪ੍ਰਭਾਵਸ਼ਾਲੀ ਹਨ। ਆਮ ਤੌਰ 'ਤੇ, ਢੁਕਵੀਂ ਦੇਖਭਾਲ ਨਾਲ, ਤੁਸੀਂ ਆਪਣੀਆਂ ਸਧਾਰਨ ਗਤੀਵਿਧੀਆਂ ਅਤੇ ਸ਼ੌਕਾਂ ਵੱਲ ਪੂਰੀ ਵਾਪਸੀ ਦੀ ਉਮੀਦ ਕਰ ਸਕਦੇ ਹੋ।

ਕਦੋਂ ਕਿਸੇ ਡਾਕਟਰ ਨੂੰ ਦਿਖਾਉਣਾ ਹੈ

ਜੇਕਰ ਤੁਹਾਨੂੰ ਠੀਕ ਹੋਣ 'ਤੇ ਨਾ ਆਉਣ ਵਾਲੀ ਲਗਾਤਾਰ ਦਰਦ ਹੈ, ਤਾਂ ਆਪਣੇ ਡਾਕਟਰ ਨੂੰ ਦਿਖਾਓ। ਉਂਗਲੀ ਵਿੱਚ ਕਮਜ਼ੋਰੀ ਜਾਂ ਅਸਥਿਰਤਾ ਨਜ਼ਰ ਆਉਣ 'ਤੇ ਮਾਹਰ ਦੀ ਸਮੀਖਿਆ ਲਈ ਕਹੋ। ਜੇਕਰ ਜੋੜ ਅਟਕ ਜਾਂਦਾ ਹੈ ਜਾਂ ਢਹਿ ਜਾਂਦਾ ਹੈ, ਤਾਂ ਇਲਾਜ ਲਓ। ਜੇਕਰ ਲੱਛਣ ਤੁਹਾਡੀ ਨੀਂਦ ਜਾਂ ਕੰਮ ਵਿੱਚ ਰੁਕਾਵਟ ਪਾਉਂਦੇ ਹਨ, ਤਾਂ ਆਪਣੇ ਡਾਕਟਰ ਨਾਲ ਸੰਪਰਕ ਕਰੋ। ਤੁਹਾਡੀ ਸਥਿਤੀ ਦਾ ਅਚਾਨਕ ਖਰਾਬ ਹੋਣਾ ਮਦਦ ਲੈਣ ਦਾ ਇੱਕ ਕਾਰਨ ਵੀ ਹੈ। ਮੈਲੇਟ ਫਿੰਗਰ ਚੋਟਾਂ ਕਈ ਵਾਰ ਦੋਹਾਂ ਪਾਸਿਓਂ ਹੋ ਸਕਦੀਆਂ ਹਨ, ਭਾਵ ਦੋਵੇਂ ਹੱਥ ਪ੍ਰਭਾਵਿਤ ਹੁੰਦੇ ਹਨ। ਬਾਇਓਕੈਮੀਕਲ ਅਸਧਾਰਨਤਾਵਾਂ ਵੀ ਇਨ੍ਹਾਂ ਚੋਟਾਂ ਵਿੱਚ ਭੂਮਿਕਾ ਨਿਭਾ ਸਕਦੀਆਂ ਹਨ। ਜਲਦੀ ਮੁਲਾਂਕਣ ਇਹ ਤੈਅ ਕਰਨ ਵਿੱਚ ਮਦਦ ਕਰਦਾ ਹੈ ਕਿ ਤੁਹਾਨੂੰ ਸਧਾਰਨ ਇਮੋਬੀਲਾਈਜ਼ੇਸ਼ਨ (ਸਥਿਰ ਕਰਨ) ਦੀ ਲੋੜ ਹੈ ਜਾਂ ਹੋਰ ਇਲਾਜ। ਤੁਹਾਡਾ ਸਰਜਨ ਤੁਹਾਡੀ ਖਾਸ ਸਥਿਤੀ ਲਈ ਸਭ ਤੋਂ ਵਧੀਆ ਅਗਲੇ ਕਦਮਾਂ ਬਾਰੇ ਤੁਹਾਨੂੰ ਦਿਸ਼ਾ-ਨਿਰਦੇਸ਼ ਦੇਵੇਗਾ।


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Absolute indications for surgical intervention for mallet fingers in pediatric populations remain unclear [1].
  • Delayed surgical management of bony mallet fingers demonstrated adequate functional outcomes with minimal complications compared with prior literature [2].
  • Both surgical and nonsurgical treatments of mallet finger injuries lead to excellent clinical outcomes [3].
  • Most authorities splint only the distal joint for mallet finger deformities [4].
  • Complication rates for large-fragment mallet finger cases are low, suggesting they can be effectively managed conservatively [5].
  • Most mallet finger injuries can be managed non-surgically with splinting, although surgery is occasionally recommended for acute or chronic cases or for salvage of failed prior treatment [6].
  • The role of surgery for mallet fractures of the thumb remains unclear due to their uncommon nature and favorable radiographic findings [7].
  • After a mallet-finger injury treated within two weeks by either splinting method, few patients have significant persistent disability [8].
  • Some authors propose treating all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which is treated with extra-articular pinning [9].
  • The conservative treatment of mallet finger with a simple splint is recommended as an alternative means of treatment [14].
  • There was insufficient evidence from comparisons tested within randomised controlled trials to establish the relative effectiveness of different, either custom-made or off-the-shelf, finger splints used for treating mallet finger injury [15].
  • Surgery is generally indicated in the case of mallet fractures involving more than one-third of the articular surface as well as in all patients who develop volar subluxation of the distal phalanx [16].
  • A significant advantage of surgical management even in complicated cases (fractures >1/3 articular surface or volar subluxation) has yet to be clearly proven [16].

Anatomy & Pathophysiology

  • The mallet finger deformity is characterized by a loss of active distal interphalangeal (DIP) joint extension with full passive range of motion evident [18].
  • The deformity reflects the loss of normal extensor force transmission via the terminal tendon insertion onto the distal phalanx [18].
  • The unopposed flexor digitorum profundus pulls the distal joint into flexion [18].
  • The usual mechanism of injury involves sudden passive flexion of an actively extended DIP joint [18].
  • Disruption of the terminal tendon may be entirely confined to the tendon or may involve an avulsed fracture fragment from the dorsal lip of the distal phalanx proximal articular surface [18].
  • The clinical appearance of soft tissue and bony mallet fingers is similar because the avulsed fragment includes the terminal tendon insertion [18].
  • The distal joint rests in flexion, a posture that cannot be actively changed [18].
  • Full passive extension of the DIP joint is possible [18].
  • Mallet finger most commonly involves a closed rupture of the terminal tendon with or without associated fracture of the distal phalanx [34].
  • Snagging the extending finger on an object that suddenly flexes the DIP joint is a frequent cause of injury [34].
  • Less commonly, a forceful hyperextension injury of the DIP joint may result in a large fracture of the base of the distal phalanx involving one-third or more of the articular surface [34].
  • Elderly patients with osteoarthritis of the DIP joint may have mallet deformities that are not related to trauma [34].
  • Individuals with hyperlax joints may have multiple pseudomallet swan neck postures that are unrelated to trauma [34].
  • Open mallet injuries are uncommon [34].
  • The most frequently involved digits are the small, ring, and middle fingers of the dominant hand [34].
  • There is a male predominance in mallet finger incidence [34].
  • Tendinous mallet fingers have been reported to occur from age 11 onward [34].
  • In skeletally immature individuals, a transepiphyseal plate fracture may be seen [34].
  • There may be a familial predisposition to mallet fingers [34].
  • The terminal tendon is the primary structure responsible for extending the DIP joint [46].
  • Adjacent retinacular structures provide stability to the DIP joint [46].
  • Palmar subluxation of a DIP joint without preexisting arthritic deformity is expected when more than one half of the dorsal articular surface is injured [47].
  • A mallet finger caused by avulsion of the extensor tendon from the distal phalanx can be satisfactorily treated by splinting 12 weeks after injury [13].
  • Prolonged splinting and splinting longer than 12 weeks may be successful, though the duration may be limited by the patient’s tolerance [13].
  • After 12 weeks, if the distal phalanx droops severely but passive extension in the DIP joint is still satisfactory, surgery may be indicated depending on patient needs [13].
  • Displacement of the epiphysis of the distal phalanx can cause the digit to assume a mallet finger posture [13].
  • Hyperextension of the phalanx usually affords satisfactory reduction of a displaced epiphysis [13].

Classification

  • Most mallet finger injuries can be managed non-surgically with splinting [6].
  • Surgery is occasionally recommended for acute or chronic cases of mallet finger [6].
  • Surgery is occasionally recommended for salvage of failed prior treatment of mallet finger [6].
  • The authors propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger [9].
  • Stage IV mallet finger is treated with extra-articular pinning [9].
  • A modification to the Doyle classification is proposed to make it more encompassing and less prone to interobserver error [31].
  • The interrater reliability of the Kellgren & Lawrence classification system for post-traumatic osteoarthritis in the distal interphalangeal joint after mallet finger fractures is considerably lower than initially assumed [36].
  • The interrater reliability of the OARSI classification system for post-traumatic osteoarthritis in the distal interphalangeal joint after mallet finger fractures is considerably lower than initially assumed [36].
  • The modified Mallet classification demonstrated strong to excellent agreement and interrater reliability across face-to-face, live tele-assessment, and video-based conditions [37].
  • The modified Mallet classification is appropriate for remote medical follow-up [37].
  • Non-operative management of mallet fractures is safe regardless of fracture classification [38].
  • Non-operative management of mallet fractures is safe regardless of joint congruence [38].
  • Non-operative management of mallet fractures is safe regardless of pre-existing degenerate change in the DIP joint [38].

Clinical Presentation

  • Mallet finger injuries are frequent in football [19].
  • Mallet deformity accounts for a minority of sporting injuries [28].
  • Bilateral mallet fingers raise questions regarding the possible role of biochemical abnormalities in causing the condition [20].
  • Approximately 50% of patients with a mallet fracture involving more than one-third of the articular surface of the distal phalanx do not progress to subluxation of the distal interphalangeal (DIP) joint [21].
  • Fracture size is an independent risk factor for the development of DIP joint subluxation in mallet fracture [21].
  • Time to application of a finger immobilizer is an independent risk factor for the development of DIP joint subluxation in mallet fracture [21].
  • Conservative management of tendinous mallet finger injuries neglected for 2 to 4 weeks can be treated as well as those presenting within the first 2 weeks of injury, with low long-term complication rates [12].
  • Surgery is occasionally recommended for acute or chronic cases of mallet finger or for salvage of failed prior treatment [6].
  • Uncomplicated cases of mallet injuries are best treated by splinting therapy [29].
  • Cases that do not react to splinting therapy are best treated by surgical interventions [29].
  • The authors propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which is treated with extra-articular pinning [9].
  • Early recognition of mallet finger injuries and referrals to a hand surgeon are crucial to avoid long-term disability [11].

Investigations

  • Most authorities recommend splinting only the distal joint for mallet finger deformities [4].
  • A radiograph should be obtained to determine whether a fracture is present [18].
  • Radiographs should be evaluated to assess if the dorsal fragment is large and whether the distal phalanx is subluxed palmarward [18].
  • Approximately 50% of patients with a mallet fracture involving more than one-third of the articular surface of the distal phalanx do not progress to subluxation of the DIP joint [21].
  • Fracture size and time to application of finger immobilizer are independent risk factors for the development of DIP joint subluxation in mallet fracture [21].
  • Surgery is generally indicated in cases of mallet fractures involving more than one-third of the articular surface [16].
  • Surgery is generally indicated in all patients who develop volar subluxation of the distal phalanx [16].
  • The advantage of surgical management for complicated cases (large fractures or subluxation) has yet to be clearly proven [16].

Treatment

Non-Operative Management

  • Surgery is occasionally recommended for acute or chronic cases or for salvage of failed prior treatment [6].
  • Conservative management of tendinous mallet finger injuries neglected for 2 to 4 weeks can be treated as well as those presenting within the first 2 weeks, with low long-term complication rates [12].
  • A simple splint is recommended as an alternative means of treating mallet finger [14].
  • There was insufficient evidence from randomized controlled trials to establish the relative effectiveness of different custom-made or off-the-shelf finger splints for treating mallet finger injury [15].
  • Supplemental night splinting does not improve outcomes in terms of extensor lag, disability, or satisfaction with treatment [22].
  • A hand therapist can treat type 1 mallet finger injuries as effectively as a surgeon [24].
  • A hand therapist can treat type 1 mallet finger injuries as effectively as a surgeon, using an immobilization method that offers practically no complications regarding skin condition [32].
  • Hand therapists implement a diverse range of clinical skills to optimize outcome success [23].
  • The clinical efficacy of elastic taping for the treatment of mallet finger injuries remains to be tested vigorously [27].

Operative Management

  • A significant advantage of surgical management over conservative management in complicated cases (fracture >1/3 articular surface or volar subluxation) has yet to be clearly proven [16].
  • Surgical management may be considered for acute and chronic mallet lesions in patients who have failed nonsurgical treatment [30].
  • Surgical management may be considered for acute and chronic mallet lesions in patients unable to work with the splint in position [30].
  • Surgical management may be considered for acute and chronic mallet lesions in patients with a fracture involving more than one third of the joint surface [30].
  • A deepithelialised pedicled skin flap technique is a new reliable alternative in the treatment of chronic mallet finger [25].
  • Scar overlapping suture for treating chronic tendinous mallet finger in children is safe and effective [33].

Surgical Technique Details

  • A mallet finger caused by avulsion of the extensor tendon from the distal phalanx can be satisfactorily treated by splinting 12 weeks after injury, as described for an acute injury [13].
  • Prolonged splinting and splinting longer than 12 weeks may be successful, though duration may be limited by patient tolerance [13].
  • After 12 weeks, if the distal phalanx droops severely but passive extension in the distal interphalangeal joint is still satisfactory, surgery may be indicated depending on patient needs [13].
  • For surgical repair of chronic mallet finger, make a small V-shaped or U-shaped incision, convex distally, with the tip no closer than 5 mm proximal to the nail base on the dorsum of the finger [13].
  • Avoid injury to the germinal matrix of the nail during incision for chronic mallet finger repair [13].
  • Develop the flap gently in the plane between the tendon and subcutaneous fat, elevating proximally to expose the extensor tendon with intervening scar [13].
  • Attempt to identify the junction of normal tendon with scar and sever the tendon transversely proximal to the joint, leaving the insertion of the tendon into bone [13].
  • Resect sufficient scar or tendon to allow closure of the gap with the finger in maximal extension [13].
  • Support and protect the repair by immobilizing the joint with a transarticular 0.045-inch Kirschner wire [13].
  • Repair the extensor tendon with 4-0 monofilament nylon or 4-0 monofilament wire as a pull-out roll stitch [13].
  • No additional sutures are required for the tendon repair in chronic mallet finger surgery [13].
  • Close the skin with interrupted 5-0 nylon or use 4-0 nylon as a dermotondermal suture [13].
  • Maintain the finger in extension and apply a compressive dressing post-operatively [13].
  • Support the finger with a volar splint for post-operative comfort and to avoid reinjury in the recovery period [13].
  • Sutures are removed at 10 to 14 days post-operatively [13].
  • The distal joint is maintained in extension, with the Kirschner wire protected by a small metal splint, for 4 weeks post-operatively [13].
  • The Kirschner wire is removed after 4 to 6 weeks post-operatively [13].
  • The repair is protected with a splint for 8 weeks post-operatively [13].
  • Normal activities are progressively resumed after the post-operative protocol [13].

Complications

  • Delayed surgical management of bony mallet fingers demonstrated minimal complications [2].
  • Conservative management of neglected tendinous mallet finger injuries (2 to 4 weeks) is associated with low long-term complication rates [12].
  • Large-fragment mallet finger cases managed conservatively have low complication rates [5].
  • Surgical treatment of acute combined tendon and bone (double level) mallet finger injuries reported no complications such as infection, nonunion, or nail deformity [17].
  • The complication rate after operative treatment of mallet fracture was 41% [41].
  • The high complication rate in operative treatment of mallet fracture is likely attributable to anatomical factors such as thin extensor tendon and poor blood supply [41].

Recovery

  • Delayed surgical management of bony mallet fingers demonstrates adequate functional outcomes with minimal complications compared with prior literature [2].
  • Large-fragment mallet finger cases can be effectively managed conservatively with low complication rates [5].
  • All cases of mallet finger are proposed to be treated with a dorsal glued splint except for stage IV mallet finger, which is treated with extra-articular pinning [9].
  • Early recognition of tendon rupture injuries and referrals to a hand surgeon are crucial to avoid long-term disability [11].
  • Surgical treatment of acute combined tendon and bone (double level) mallet finger injuries using pullout wire fixation with distal interphalangeal joint Kirschner wire stabilization reports good to excellent long-term results with no reported complications such as infection, nonunion, or nail deformity [17].
  • Mallet finger injuries are frequent in football and difficult to treat during the competitive season, often requiring delayed treatment or internal splinting [19].
  • Supplemental night splinting does not improve the outcome of mallet finger in terms of extensor lag, disability, or satisfaction with treatment [22].
  • The Fowler procedure is the safest and most effective reconstructive measure for chronic mallet finger deformity after phalangeal fracture, offering less morbidity than osteotomy or procedures restraining proximal interphalangeal joint extension [44].

Key Evidence

  • [L4] Absolute indications for surgical intervention for mallet fingers in this population remain unclear. [1] (10.1016/j.jhsa.2018.03.037)
  • [L4] Delayed surgical management of bony mallet fingers demonstrated adequate functional outcome with minimal complications when compared with prior literature. [2] (10.1177/1558944719840749)
  • [L4] Both surgical and nonsurgical treatments of mallet finger injuries lead to excellent clinical outcomes. [3] (10.1016/j.jhsa.2017.10.004)
  • [L5] Today most authorities splint only the distal joint for mallet finger deformities. [4] (10.1016/s0749-0712(21)00059-7)
  • [L4] Complication rates were low, suggesting that large-fragment mallet finger cases can be effectively managed conservatively. [5] (10.1186/s12891-026-09787-w)
  • [L5] Most mallet finger injuries can be managed non-surgically with splinting, although surgery is occasionally recommended for acute or chronic cases or for salvage of failed prior treatment. [6] (10.1007/s11552-014-9609-y)
  • [L3] The role of surgery for mallet fractures of the thumb remains unclear due to their uncommon nature and favorable radiographic findings. [7] (10.1177/1558944716672192)
  • [L1] After a mallet-finger injury treated within two weeks by either method few patients have significant persistent disability. [8] (10.1016/s0072-968x(82)80011-9)
  • [L5] The authors propose to treat all cases of mallet finger with a dorsal glued splint except for stage IV mallet finger, which they treat with extra-articular pinning. [9] (10.5999/aps.2016.43.2.134)
  • [L4] Early recognition of these injuries and referrals to a hand surgeon for treatment are crucial to avoid longterm disability. [11] (10.1016/j.hcl.2012.05.042)
  • [L3] Conservative management of tendinous mallet finger injuries that have been neglected for 2 to 4 weeks can be treated as well as those injuries in patients presenting within the first 2 weeks of injury with low long-term complication rates. [12] (10.1016/j.jhsa.2014.06.140)
  • [L2] The study recommends this splint as an alternative means of treating mallet finger. [14] (10.1136/emj.10.3.244)
  • [L1] There was insufficient evidence from comparisons tested within randomised controlled trials to establish the relative effectiveness of different, either custom-made or off-the-shelf, finger splints used for treating mallet finger injury. [15] (10.1002/14651858.cd004574.pub2)
  • [L4] Although surgery is generally indicated in the case of mallet fractures involving more than one-third of the articular surface as well as in all patients who develop volar subluxation of the distal phalanx, a significant advantage of surgical management even in those complicated cases has yet to be clearly proven. [16] (10.1177/1558944716642763)
  • [L4] The study describes a surgical technique for acute combined tendon and bone mallet fingers and reports good to excellent long-term results with no reported complications such as infection, nonunion, or nail deformity in the series. [17] (10.1016/j.jhsa.2014.11.011)
  • [L5] Mallet finger injuries are frequent in football and difficult to treat during the competitive season, often requiring delayed treatment or internal splinting. [19] (10.1016/j.hcl.2012.05.043)
  • [L4] This case raises a question regarding the possible role of biochemical abnormalities causing mallet fingers. [20] (10.1177/175899830400900103)
  • [L2] Approximately 50% of patients with a mallet fracture involving more than one-third of the articular surface of the distal phalanx do not progress to subluxation of the DIP joint; fracture size and time to application of finger immobilizer are independent risk factors for the development of DIP joint subluxation in mallet fracture. [21] (10.1177/1753193414554556)
  • [L1] Supplemental night splinting does not improve the outcome of mallet finger in terms of extensor lag, disability, or satisfaction with treatment. [22] (10.1007/s11552-013-9600-z)
  • [L4] Hand therapists implement a diverse range of clinical skills to optimise outcome success. [23] (10.1177/1758998316664822)
  • [L4] A hand therapist can treat type 1 mallet finger injuries as effectively as a surgeon. [24] (10.1197/j.jht.2008.04.002)
  • [Paper] This method seems to be a new reliable alternative in the treatment of chronic mallet finger. [25] (10.1016/j.injury.2013.01.013)
  • [L4] The clinical efficacy of the proposed method of elastic taping for the treatment of mallet finger injuries remains to be tested vigorously. [27] (10.1016/j.jht.2014.02.005)
  • [L4] Mallet deformity accounts for a minority of sporting injuries, but excellent functional outcome can be achieved with splintage and avoidance of the causative sport while splinted. [28] (10.1054/jhsb.2000.0484)
  • [L4] Uncomplicated cases of mallet injuries are best treated by splinting therapy; cases that do not react to splinting therapy are best treated by surgical interventions. [29] (10.1097/prs.0b013e3181ef8ec8)
  • [L5] Surgical management may be considered for acute and chronic mallet lesions in patients who have failed nonsurgical treatment, are unable to work with the splint in position, or have a fracture involving more than one third of the joint surface. [30] (10.5435/00124635-200509000-00007)
  • [L4] This article provides a topical review of the contemporary literature concerning acute mallet finger injuries and proposes a modification to the Doyle classification to make it more encompassing and less prone to interobserver error. [31] (10.1016/j.jhsa.2022.10.013)
  • [L4] A hand therapist can treat mallet finger injuries of type 1 as effectively as a surgeon, with a method of immobilisation that offers practically no complications regarding skin condition. [32] (10.1177/175899830501000103)
  • [L4] Scar overlapping suture for treating chronic tendinous mallet finger in children is safe and effective. [33] (10.1186/s13018-019-1106-0)
  • [L4] The interrater reliability of the Kellgren & Lawrence and OARSI classification systems for post-traumatic osteoarthritis in the distal interphalangeal joint after mallet finger fractures is considerably lower than initially assumed. [36] (10.1016/j.jhsa.2024.03.012)
  • [L3] The modified Mallet classification demonstrated strong to excellent agreement and interrater reliability across face-to-face, live tele-assessment, and video-based conditions, suggesting it is appropriate for remote medical follow-up. [37] (10.1177/17531934231196118)
  • [L3] Non-operative management of mallet fractures, regardless of fracture classification, joint congruence or pre-existing degenerate change in the DIP joint, is safe and yields predictably good outcomes in most patients. [38] (10.1177/1753193421992986)
  • [L4] The complication rate after operative treatment of mallet fracture was 41%, likely attributable to anatomical factors such as thin extensor tendon and poor blood supply. [41] (10.1054/jhsb.2000.0440)
  • [Case_report] The Fowler procedure was the safest and most effective reconstructive measure for this chronic mallet finger deformity, offering less morbidity than osteotomy or procedures restraining proximal interphalangeal joint extension. [44] (10.2106/00004623-197759040-00019)
  • [L5] The TT is the primary structure responsible for extending the distal interphalangeal (DIP) joint, while adjacent retinacular structures provide stability. [46] (10.1016/j.jhsa.2004.04.022)
  • [L5] Palmar subluxation of a DIP joint without preexisting arthritic deformity is expected when more than one half of the dorsal articular surface is injured. [47] (10.1016/j.jhsa.2007.09.006)

References

[1] Outcomes of Splinting in Pediatric Mallet Finger. The Journal of Hand Surgery. 2018. DOI: 10.1016/j.jhsa.2018.03.037

[2] Delayed Extension Block Pinning in 27 Patients With Mallet Fracture. HAND. 2019. DOI: 10.1177/1558944719840749

[3] Surgical and Nonsurgical Management of Mallet Finger: A Systematic Review. The Journal of Hand Surgery. 2018. DOI: 10.1016/j.jhsa.2017.10.004

[4] EXTENSOR TENDON INJURIES AT THE DISTAL INTERPHALANGEAL JOINT. Hand Clinics. 1995. DOI: 10.1016/s0749-0712(21)00059-7

[5] Surgical versus conservative management of Doyle type 4c mallet finger: a comparative study. BMC Musculoskeletal Disorders. 2026. DOI: 10.1186/s12891-026-09787-w

[6] Current Concepts: Mallet Finger. HAND. 2014. DOI: 10.1007/s11552-014-9609-y

[7] Mallet Fractures of the Thumb Compared With Mallet Fractures of the Fingers. HAND. 2016. DOI: 10.1177/1558944716672192

[8] Mallet-Finger Injuries: A Prospective, Controlled Trial of Internal and External Splintage.. Hand. 1982. DOI: 10.1016/s0072-968x(82)80011-9

[9] Review of Acute Traumatic Closed Mallet Finger Injuries in Adults. Archives of Plastic Surgery. 2016. DOI: 10.5999/aps.2016.43.2.134

[11] Tendon Ruptures: Mallet, FDP and ECRB Tendon Ruptures Associated with Lunotriquetral Coalitions in Professional Basketball Players. Hand Clinics. 2012. DOI: 10.1016/j.hcl.2012.05.042

[12] Soft-Tissue Mallet Injuries: A Comparison of Early and Delayed Treatment. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.06.140

[13] Campbell S Operative Orthopaedics 4 Volume Set. RECONSTRUCTION OF FINGER FLEXORS: SINGLE-STAGE TENDON GRAFT > CHRONIC MALLET FINGER (SECONDARY REPAIR).

[14] The conservative treatment of mallet finger with a simple splint: a case report.. Emergency Medicine Journal. 1993. DOI: 10.1136/emj.10.3.244

[15] Interventions for treating mallet finger injuries. Cochrane Database of Systematic Reviews. 2004. DOI: 10.1002/14651858.cd004574.pub2

[16] The Diagnosis and Management of Mallet Finger Injuries. HAND. 2016. DOI: 10.1177/1558944716642763

[17] Pullout Wire Fixation Together With Distal Interphalangeal Joint Kirschner Wire Stabilization for Acute Combined Tendon and Bone (Double Level) Mallet Finger Injury. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2014.11.011

[18] A Lange Medical Book Current Diagnosis Treatment In Orthopedics Fifth Edition. 9Hand Surgery > 3. Mallet Finger.

[19] Tendon Ruptures: Mallet, FDP in Football. Hand Clinics. 2012. DOI: 10.1016/j.hcl.2012.05.043

[20] Bilateral Mallet Fingers: A Case Study. The British Journal of Hand Therapy. 2004. DOI: 10.1177/175899830400900103

[21] The risk factors associated with subluxation of the distal interphalangeal joint in mallet fracture. Journal of Hand Surgery (European Volume). 2014. DOI: 10.1177/1753193414554556

[22] A Prospective Randomized Controlled Trial Comparing Night Splinting with No Splinting after Treatment of Mallet Finger. HAND. 2014. DOI: 10.1007/s11552-013-9600-z

[23] How do hand therapists conservatively manage acute, closed mallet finger? A survey of members of the British Association of Hand Therapists. Hand Therapy. 2016. DOI: 10.1177/1758998316664822

[24] Hand Therapist-led Management of Mallet Finger. Journal of Hand Therapy. 2008. DOI: 10.1197/j.jht.2008.04.002

[25] A new surgical treatment for mallet finger deformity: Deepithelialised pedicled skin flap technique. Injury. 2013. DOI: 10.1016/j.injury.2013.01.013

[27] A novel way of treating mallet finger injuries. Journal of Hand Therapy. 2014. DOI: 10.1016/j.jht.2014.02.005

[28] Mallet Deformity in Sport. Journal of Hand Surgery. 2001. DOI: 10.1054/jhsb.2000.0484

[29] Treatment Options for Mallet Finger: A Review. Plastic and Reconstructive Surgery. 2010. DOI: 10.1097/prs.0b013e3181ef8ec8

[30] Mallet Finger. Journal of the American Academy of Orthopaedic Surgeons. 2005. DOI: 10.5435/00124635-200509000-00007

[31] Acute Mallet Finger Injuries—A Review. The Journal of Hand Surgery. 2023. DOI: 10.1016/j.jhsa.2022.10.013

[32] Hand Therapist-led Management of Mallet Finger. The British Journal of Hand Therapy. 2005. DOI: 10.1177/175899830501000103

[33] Scar overlapping suture for treating chronic tendinous mallet finger in children. Journal of Orthopaedic Surgery and Research. 2019. DOI: 10.1186/s13018-019-1106-0

[34] Green S Operative Hand Surgery. CASE STUDY 5.2 Unusual Mallet Finger Presentation.

[36] Rater Agreement of Post-Traumatic Osteoarthritis of the Distal Interphalangeal Joint 12 Years After a Mallet Finger Fracture. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2024.03.012

[37] Interrater reliability of face-to-face, tele- and video-based assessments with the modified Mallet classification in brachial plexus birth injuries. Journal of Hand Surgery (European Volume). 2023. DOI: 10.1177/17531934231196118

[38] The non-operative management of bony mallet injuries. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/1753193421992986

[41] Complications of Operative Treatment for Mallet Fractures of the Distal Phalanx. Journal of Hand Surgery. 2001. DOI: 10.1054/jhsb.2000.0440

[44] Mallet deformity of a finger after phalangeal fracture. Case report of treatment by the Fowler procedure. The Journal of Bone & Joint Surgery. 1977. DOI: 10.2106/00004623-197759040-00019

[46] The terminal tendon of the digital extensor mechanism: Part I, anatomic study. The Journal of Hand Surgery. 2004. DOI: 10.1016/j.jhsa.2004.04.022

[47] A Biomechanical Study of Distal Interphalangeal Joint Subluxation After Mallet Fracture Injury. The Journal of Hand Surgery. 2008. DOI: 10.1016/j.jhsa.2007.09.006

Creative Commons BY-NC 4.0

CC Creative Commons licence
BY Attribution — you must credit the source
NC NonCommercial — not for commercial use

Attribution-NonCommercial 4.0 International


Creative Commons Corporation ("Creative Commons") is not a law firm and does not provide legal services or legal advice. Distribution of Creative Commons public licenses does not create a lawyer-client or other relationship. Creative Commons makes its licenses and related information available on an "as-is" basis. Creative Commons gives no warranties regarding its licenses, any material licensed under their terms and conditions, or any related information. Creative Commons disclaims all liability for damages resulting from their use to the fullest extent possible.

Using Creative Commons Public Licenses

Creative Commons public licenses provide a standard set of terms and conditions that creators and other rights holders may use to share original works of authorship and other material subject to copyright and certain other rights specified in the public license below. The following considerations are for informational purposes only, are not exhaustive, and do not form part of our licenses.

Considerations for licensors: Our public licenses are intended for use by those authorized to give the public permission to use material in ways otherwise restricted by copyright and certain other rights. Our licenses are irrevocable. Licensors should read and understand the terms and conditions of the license they choose before applying it. Licensors should also secure all rights necessary before applying our licenses so that the public can reuse the material as expected. Licensors should clearly mark any material not subject to the license. This includes other CC- licensed material, or material used under an exception or limitation to copyright. More considerations for licensors: wiki.creativecommons.org/Considerations_for_licensors

Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees


Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.


Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

Creative Commons may be contacted at creativecommons.org.