A 13-year-old male presented in the emergency department with his little finger of the nondominant hand injured while playing basketball. An axial compression with an excessive hyperextension was applied to the tip of his finger while he tried to steal the ball during the game.
On physical examination, the finger was found to be deformed, swollen and very painful in performing any movement. There were no signs of neurovascular damage or skin lesion. Initial plain radiographs demonstrated a dorsal dislocation of PIP and DIP joints of his little finger in a step-ladder deformity (Figure 1). Anatomical reduction was easily obtained with a simple and gentle longitudinal traction. Following reduction, both joints were stable and confirmed on plain radiographs with no apparent any bony avulsion fragment or fracture (Figure 1). After that, buddy taping with the ring finger was applied for two weeks, and the patient was advised to mobilize the PIP and DIP joints as long as the discomfort allowed him.
At 3 weeks of follow-up, the buddy taping was removed, and he had full extension of both joints, with flexion of the DIP joint to 50  and the PIP joint to 90 . At 6 weeks of follow-up, the patient had full active range of motion. Within 3 months after the reduction, the patient returned to previous level of musical activities (piano playing) without limitation of motion.