Surgery might be offered if the mallet fracture includes a large bone fragment or if the joint is not in line (figure). 


Figure: dislocated bony fragment.

Surgery usually consists of temporary pins that can be removed in the office after 4 to 6 weeks (figure). Surgery allows a better alignment of the bone but includes a slightly higher risk of complications than splints.


Figure: x-ray of mallet finger treated with a temporary pin.