Ortho Dx: Deformity, pain in middle finger


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A patient, aged 16 years, presented with pain and deformity of the right middle finger. He reported injuring the finger playing football two days prior. He was unable to extend the tip of his finger since the injury.

On exam, a flexion deformity at the distal interphalangeal joint was found. The patient was unable to extend his distal phalanx. Anteroposterior (AP) and lateral x-rays were taken.

The x-rays show a bony mallet finger. Bony mallet fractures result from a forceful impaction to the distal phalanx causing the extensor tendon to pull off a piece of bone. The patient should be treated in a volar splint at...

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