60 patients with distal interphalangeal joint (DIPj) active extensor lag were randomized to determine the efficacy between cast immobilization treatment using either a Quickcast orthosis to be worn 24 hours a day or a removable, low temperature thermoplastic, lever-type orthosis. After 24-28 weeks, there were no significant differences between the two groups in regard to success rate, orthosis discomfort, satisfaction with orthotic design, DIPj flexion stiffness, incidence of complications, and grip and tip-to-tip pinch strengths. However, the Quickcast group experienced significantly greater active extension at the distal interphalangeal joint at 10-12 weeks and significantly less edema at 6-8 weeks compared to the low temperature thermoplastic, lever-type orthosis group.