A 19-year-old rugby player sustains a forced hyperextension injury to the distal interphalangeal joint while catching a ball. He is unable to actively extend the DIP joint, and the fingertip rests in 30 degrees of flexion. Radiographs show no fracture. The recommended initial management is:

• A Open repair with a pull-out wire suture through the distal phalanx
• B Early active mobilization with a buddy strap
• C Extension splinting of both PIP and DIP joints for 4 weeks
• D Extension splinting of the DIP joint continuously for 6-8 weeks ✓

Explanation

Closed mallet finger without fracture is managed with continuous DIP extension splinting for 6-8 weeks to approximate the extensor tendon ends. The PIP joint is left free. Open surgery is reserved for large bony avulsions, volar subluxation of the distal phalanx, or failed conservative treatment.

Reference: Green's Operative Hand Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.