For a Mallet finger injury, how should the DIP be immobilized?

For a Mallet finger injury, how should the DIP be immobilized?

• A. Immobilize in full extension for 6-8 weeks WITHOUT FLEXING
• B. Immobilize with the DIP in flexion
• C. Immobilize the DIP with the PIP flexed
• D. Remove splint after 2 weeks

Answer: (A)

Immobilizing the DIP in full extension lets the terminal extensor tendon heal in the length it’s meant to be, preventing a persistent flexed posture and extension lag. In a mallet finger, the injury disrupts the extensor mechanism at the distal phalanx, often with a small bony avulsion. Keeping the DIP extended maintains tension on the repaired or reattaching tendon, promoting proper healing. Extending the DIP for about 6–8 weeks with a splint provides time for the tendon or bone fragment to secure, and removing the splint after only 2 weeks would be premature and increase the risk of a deformity. Immobilizing in flexion, or with the PIP flexed, fails to restore the extensor mechanism and would not correct the deformity.

Immobilizing the DIP in full extension lets the terminal extensor tendon heal in the length it’s meant to be, preventing a persistent flexed posture and extension lag. In a mallet finger, the injury disrupts the extensor mechanism at the distal phalanx, often with a small bony avulsion. Keeping the DIP extended maintains tension on the repaired or reattaching tendon, promoting proper healing. Extending the DIP for about 6–8 weeks with a splint provides time for the tendon or bone fragment to secure, and removing the splint after only 2 weeks would be premature and increase the risk of a deformity. Immobilizing in flexion, or with the PIP flexed, fails to restore the extensor mechanism and would not correct the deformity.