A 28-year-old wicketkeeper jams his right little finger while catching a ball. He cannot extend the distal phalanx actively, and X-ray shows a small flake of bone avulsed from the dorsal base of the distal phalanx with less than 25 percent articular involvement. The most appropriate initial treatment is:
- A Closed reduction and percutaneous K-wire fixation of the DIP joint
- B Continuous extension splinting of the DIP joint alone for 6 to 8 weeks ✓
- C Arthrodesis of the DIP joint in 20 degrees of flexion
- D Early mobilisation with buddy taping to the ring finger
Correct answer: B. Continuous extension splinting of the DIP joint alone for 6 to 8 weeks
Explanation
This is a mallet finger from avulsion of the extensor tendon at its insertion into the distal phalanx. The standard treatment for a bony mallet with less than about 30 percent of the articular surface involved and no volar subluxation of the distal phalanx is continuous extension splinting of the DIP joint alone for 6 to 8 weeks. Buddy taping permits PIP motion but leaves the DIP unsupported, guaranteeing an extensor lag.
Reference: Green's Operative Hand Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.