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A Little Droop Is Common. Dropping Right Back Is a Different Story.
A small droop after 6 to 8 weeks of splinting is COMMON. Many mallet fingers end with the tip sitting a few degrees short of straight, and it often improves over the next few weeks with night splinting and no forcing.
A tip that drops most of the way back to where it started, as soon as the splint comes off, usually means the tendon didn’t heal. The usual answer is back into the splint full-time, and a reassessment.
The difference between the two is how far it drops, and how fast.
Where are you right now?
- Splint just came off, tip sits slightly bent: read “A small lag.”
- Splint just came off, tip dropped right back: read “It dropped back.”
- It was straight when the splint came off, and drooped over the following weeks: read “It stretched out.”
- Months later, still drooping: see mallet finger left untreated for the long-term options.
A small lag (usually fine)
The tip rests a little bent, but you can lift it most of the way on your own.
This is very common. The tendon healed, but slightly long.
- Keep the night splint going for the usual 2 to 4 more weeks, longer if your therapist advises.
- Wear it for risky tasks: sport, gardening, anything that could knock the tip bent.
- Don’t force the tip into a deep bend or stretch it for the first few weeks out of the splint.
A small lag often shrinks over a couple of months. A few degrees can remain for good, and most people stop noticing it.
It dropped back (the tendon didn’t heal)
The tip droops nearly as much as on day one, within hours or days of the splint coming off.
The most common reasons:
- The tip bent during the splint weeks. One bend, even for a second while washing, pulls the healing ends apart, and the clock restarts.
- The splint wasn’t worn full-time, or it slipped and let the tip sag.
- The splint was started late, after weeks of drooping.
The usual answer: back into full-time splinting, often for several more weeks, then a careful wean. It often still works. Get it reassessed, and ask whether an X-ray is needed.
A second round of splinting done properly beats a first round done nearly.
It stretched out (slow droop over weeks)
Straight when the splint came off, then sagging over the next weeks.
Usually the new tendon is still soft and got stretched by too much bending too soon. Back to the night splint, ease off the deep bending, and get it checked if it’s sagging week on week.
The window after the splint
- Weeks 0 to 8 (OPEN): full-time splinting. This is where most of the result is decided.
- Weeks 8 to 12 (OPEN, guarded): night splint and splint for risky tasks. A small lag can still improve.
- A drop back at any point (CLOSING): re-splint full-time promptly. The longer it hangs, the bigger the final droop.
- Months of droop despite all of that (SHUT for splinting): the goal changes. Live with it, or talk to a hand surgeon if it catches or a swan neck is developing.
The full splint rules are in mallet finger treatment.
(It’s called mallet finger cos the bent tip looks like a little hammer. Not Thor’s. No superpowers, just a droop.)
A small lag is a healed tendon that’s a bit long. A drop back is a tendon that hasn’t healed yet.
Is this normal?
Usually expected:
- The tip sits a few degrees short of straight when the splint first comes off.
- The last joint feels stiff and won’t bend fully for a few weeks.
- Some redness or a small bump over the back of the joint.
Check with your doctor or therapist if the droop is increasing week on week.
If it isn’t going to plan
Eight weeks of tape, splint and careful showers. The splint comes off, and by the next morning the tip has dropped right back. It feels like eight weeks for nothing.
It isn’t for nothing, but it isn’t healed either. If you leave it hanging now, the gap fills with stretched scar and the droop sets. Waiting until it “tightens up on its own” is the one plan that reliably makes it permanent.
So get back into the splint full-time today, then get it reassessed this week. A hand therapist can check the splint really holds the tip straight, check the middle joint, and set a proper wean. See which mallet finger splint is best.
Get it checked today if
- The skin over the back of the joint is broken down, white or blistered from the splint.
- The fingertip is cold, pale or numb.
Get it checked this week if
- The tip dropped most of the way back after the splint came off.
- The droop is getting bigger week on week.
- The middle joint is starting to bend backward as the tip droops.
A few degrees of droop is a result. A drop back is a restart.
Written by Nigel Chua, hand occupational therapist in practice since 2005. Thousands of hands, wrists and elbows assessed and treated. My credentials are here. This article explains; it doesn’t examine. If your fingertip dropped back after the splint came off, get back into it full-time and get it reassessed this week.
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.