Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute onset of distal interphalangeal (DIP) joint pain and inability to actively extend the digit following a traumatic axial load injury. Patient reports localized swelling and tenderness over the dorsal aspect of the DIP joint. No history of prior injury or surgical intervention to the affected digit.
Clinical Examination Findings
Physical examination reveals a characteristic flexion deformity of the DIP joint. Active extension of the DIP joint is absent, while passive extension remains full. Tenderness is localized to the dorsal base of the distal phalanx. Neurovascular status is intact with distal capillary refill < 2 seconds. No signs of skin compromise or nail bed injury.
Treatment Protocol
Immobilization of the DIP joint in neutral or slight hyperextension using a custom-molded thermoplastic splint (stack splint or dorsal mallet splint). Splint must be worn continuously for 6-8 weeks. Patient instructed to avoid removing the splint during hygiene to prevent flexion of the DIP joint. Follow-up scheduled to assess skin integrity and splint fit.