Seventy patients with nonsurgical mallet finger were randomized to receive either a 3-point prefabricated orthosis and elastic tape (n=37) or cast immobilization (n=33) for 6 weeks. The primary outcome was distal interphalangeal (DIP) joint extension lag. Secondary outcomes included DIP joint flexion deficit, pain (Numeric Pain Rating Scale), and function (brief Michigan Hand Questionnaire). Outcomes were assessed at 12 weeks and 6 months after immobilization. Overall, the results of the study revealed no statistically or clinically significant differences between the two groups in any of the outcome measures at either timepoint. Both treatment modalities yielded good functional and pain outcomes, supporting either method as an appropriate option for nonsurgical mallet finger management.