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Resolution of the case is described on the next page.
Diagnosis: The x-ray reveals a fracture at the base of the distal phalanx (arrow), but what is most important is that it is consistent with a mallet deformity of the DIP. If this injury is not properly managed from the beginning, it can lead to serious complications in the future. The finger must be placed in a metal splint with the DIP in hyperextension. Immediate referral to a hand surgeon is needed for this patient.
Acknowledgement: Case presented by Nahum Kovalski, BSc, MDCM, Terem Emergency Medical Centers, Jerusalem, Israel.
Clinical Challenge: April, 2013
Nahum Kovalski, BSc, MDCM
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