Nonoperative treatment (splinting)
Nonoperative treatment can produce excellent results, with near-normal range
of motion, due to bone remodelling, even in the presence of persisting fragment
Nonoperative treatment is based on immobilization of the DIP joint in
extension, leaving the PIP joint free.
Duration of immobilization
The DIP joint should be immobilized in extension for 8 weeks. It must be
impressed on the patient that splintage should be uninterrupted during this
It must be kept in mind that the vascularity of this area is precarious, even
in healthy patients, and healing is slow. Any shorter period of immobilization
risks re-rupture. Joint stiffness is unusual after these injuries.
Frequently, patients may complain of a dorsal prominence, and of loss of
the last 10-20 degrees of extension of the DIP joint. Dorsal tenderness rarely
persists for more than a month or so after removal of the splint.