The DIP joint allows the fingertip to flex for grasping and is stabilised by the terminal extensor tendon dorsally and the FDP insertion volarly. Mallet finger (terminal extensor tendon avulsion) and jersey finger (FDP avulsion) represent the two tendinous injury patterns at this joint. DIP joint arthritis is extremely common in older adults.
Mallet finger from terminal extensor tendon disruption produces DIP flexion deformity and inability to actively extend the fingertip. Continuous DIP extension splinting for 6-8 weeks allows tendon healing for acute injuries. Bony mallet fractures involving >30% of the articular surface may require ORIF. DIP joint arthrodesis reliably relieves arthritis pain in this joint.
Terminal extensor tendon avulsion producing DIP flexion deformity managed with continuous extension splinting for 6-8 weeks.
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