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What is Jersey Finger?
Jersey finger (also known as rugby finger) refers to an injury of the finger in which the tendon on the palm-side of a finger ruptures while actively attempting to grab something. Technically, Jersey fingers fall under zone I flexor tendon injuries. Jersey finger often occurs in sports when a player grasps the jersey of an opponent and the opponent quickly pulls away. Generally, forced extension of a flexed finger accounts for most Jersey finger injuries. The injury often involves the flexor digitorum profundus (FDP) of the ring finger, possibly due to the fact that the ring finger obtains support from both the ulnar and radial side muscles, and thus more vulnerable to hyperextension injury. Jersey finger mostly occurs during rugby and football (Bachoura, Ferikes and Lubahn, 2017).
How Severe is Jersey Finger?
Type 1: Characterized by severe tearing. Blood supply gets hugely disturbed and the tendon retracts into the palm.
Type 2: Here the tendon remains at the pulley site, although the tendon retracts.
Type 3: The tear comes off with a bony fragment and both the fracture fragment and tendon remain at the A4 pulley.
Type 4: Uncommon, and comes with a tendon tear from the bony fragment as well as a fracture. Sometimes the tendon retracts into the palm (Abrego and Shamrock, 2021).
How Do Hand and Wrist Specialists Diagnose Jersey Finger?
Patients present with the inability to make a full fist and an inability to flex the injured finger. Often, a fleck of avulsed bone pulls away along with the tendon. This gets detected at the level of the proximal interphalangeal joint (PIPJ) with the aid of radiography. A comprehensive clinical examination that rules out a PIPJ injury and correctly identifies a profundus avulsion injury helps in accurate diagnosis (Bachoura, Ferikes and Lubahn, 2017). Plain radiographs help rule out fractures while ultrasound and X-rays may play an important role. The use of MRI remains uncommon but MRI helps with accurate assessment of the increased tendon-bone distance (Abrego and Shamrock, 2021).
How Do Orthopedic Specialists Treat Jersey Finger?
Surgery remains the main treatment option for nearly all jersey finger injuries, while non-operative treatment only comes into the picture with patients unwilling or unable to comply with post-operative therapy and in cases of high-risk surgical patients. Ideally, even an acute case requires surgical treatment (Bachoura, Ferikes and Lubahn, 2017). Early surgical treatment by experts helps restore function and blood supply. Acute phase typically describes a period within three weeks of the injury. There remain several techniques for treating acute injuries with similar rates of success. Chronic injuries last more than 3 months and require treatment in different ways, depending on the nature of injury. When the patient can handle full range of motion, two-stage tendon grafting works fine. In cases with chronic stiffness, DIP joint arthrodesis suffices but some patients may need tendon reconstruction, which requires enough time commitment in order to achieve a successful long-term rehabilitation result. Patients’ expectation, goals and level of competition and position (in the case of athletes) affect treatment decisions (Abrego and Shamrock, 2021).
Excellent functional outcomes have resulted from early diagnosis and treatment (especially within the first 10 days of injury). Patients may experience no pain and full functional range of motion within 8-12 weeks (Abrego and Shamrock, 2021).
Please do not hesitate to contact us if you have any questions.
Abrego, M.O. and Shamrock, A.G. (2021). Jersey Finger. [online] Nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK545291/ [Accessed 21 Feb. 2022].
Bachoura, A., Ferikes, A.J. and Lubahn, J.D. (2017). A review of mallet finger and jersey finger injuries in the athlete. Current Reviews in Musculoskeletal Medicine, [online] 10(1), pp.1–9. Available at: https://pubmed.ncbi.nlm.nih.gov/28188545/ [Accessed 21 Feb. 2022].