Seven controlled trials comparing prefabricated orthoses to custom-made orthoses for conservative treatment of mallet injury were included in this systematic review and meta-analysis. The purpose was to compare orthosis types in terms of skin complication, degree of extensor lag and rate of treatment success/failure in order to determine whether the use of one orthoses type is advantageous over the other in terms of patient outcome. Custom-made orthoses were found to reduce the risk of skin complication compared to prefabricated orthoses, but no significant difference in extensor lag or rate of treatment success/failure was observed. Additionally, patient pain, satisfaction, and adherence was similar the two groups of orthoses.