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A randomized clinical trial, with patients treated either by new 2-step orthosis or by the figure–eight-type orthosis with the distal interphalangeal (DIP) joint extended.To report on our new orthosis and to evaluate the treatment efficacy of using a 2-step orthosis for the treatment of a mallet finger of tendinous origin compared with a conventional orthosis.Forty-four patients were randomized into the 2-step or conventional orthosis groups. Primary outcomes were active DIP joint flexion and extensor lag, pain, and the Abouna–Brown criteria.The 2-step orthosis was associated with a smaller active DIP extensor lag, compared with the conventional orthosis (−7.5 ± 4.5° vs −16.4 ± 6.9°, P = .001), combined with a significantly higher Abouna–Brown criteria (χ2 = 14.57, P = .01). No other between-group differences were identified.The therapeutic effectiveness of the 2-step orthosis, over a conventional orthosis, was supported by a large effect size of the treatment in improving residual active extensor lag at the DIP and overall Abouna–Brown criteria. Our study thus suggested that the initial immobilization involved in new 2-step orthosis and is thus a good immobilization technique.Ib.