ABSTRACT
A sudden flexion force in a stretched finger causes a closed extensor tendon rupture at the DIP joint. This often occurs when making a bed, or during ball games in young patients. In the latter case an avulsion fracture is possible. Full active extension of the DIP joint is not possible. Full passive extension is possible. If the injury has occurred during ball sports or by any other strong force, there is an indication for an X-ray to diagnose a possible bony avulsion. The splint should be worn 24 hours a day. The PIP joint remains free to allow flexion. In patients who do not adhere to therapy a trans-articular Kirschner wire can be chosen for fixation. With an open mallet finger or with an avulsion fragment larger than one third of the joint surface or in cases of subluxation of the distal phalanx, operative repair is indicated.
