A 32-year-old cricketer jams the tip of his right ring finger while fielding. He cannot extend the distal interphalangeal joint actively, and X-ray shows no bony fragment. The most appropriate treatment is:

• A Kirschner wire fixation of the DIP joint in flexion
• B Arthrodesis of the DIP joint in 20 degrees of flexion
• C Early passive mobilisation of the DIP joint
• D Continuous extension splintage of the DIP joint for about 6 weeks ✓

Explanation

This is a soft tissue mallet finger, caused by closed rupture or avulsion of the extensor tendon at its insertion into the base of the distal phalanx. Without a large bony fragment or subluxation of the distal phalanx, treatment is continuous extension splinting of the DIP joint alone for approximately 6 weeks, keeping the PIP joint free. Interrupted splinting restarts the healing clock. Arthrodesis is reserved for painful established arthritis or failed reconstruction.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.