Jersey finger: Difference between revisions
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==Background== | |||
*Avulsion of flexor tendon from distal phalanx | |||
*Occurs from forced extension of flexed DIP (historically from grabbing someone's jersey with the tip of a finger) | |||
==Clinical Features== | |||
*Inability to actively flex DIP joint | |||
*Full passive ROM is maintained | |||
==Differential Diagnosis== | |||
{{Hand and finger injury DDX}} | |||
==Evaluation== | |||
*Clinical diagnosis | |||
*[[ultrasound: Tendons|Ultrasound]] can differentiate between partial and complete rupture<ref>De Gautard G, et al. Sonography of jersey finger. J Ultrasound Med. 2009; 28(3):389-392.</ref> | |||
==Management== | |||
*[[Finger splint]] in slight flexion at DIP | |||
*Early follow-up (24-48 hours) with hand specialist - surgery is required for all Jersey finger injuries | |||
==Disposition== | |||
*Discharge | |||
===Specialty Care=== | |||
*Based on Leddy and Packer Classification<ref>Tuttle, Harrison G., MD, et al. Tendon Avultion Injuries of the Distal Phalanx. Clinical Orthopaedics and Related Research. April 2006. No. 445. Pp. 157-168.</ref> | |||
{| class="wikitable" | |||
|- | |||
! Class !! Description !! Treatment | |||
|- | |||
| I || Vincula ruptured with tendon retraction to palm || Primary tendon repair within 10 days | |||
|- | |||
| II || Vincula intact with tendon retraction to proximal interphalangeal joint || Primary tendon repair within 10 days (but may be delayed) | |||
|- | |||
| III || Fracture fragment retains tendon at distal interphalangeal joint || Repair of fracture fragment (6 weeks) | |||
|- | |||
| IV || Fracture fragment has tendon avulsed off and retracted || Repair of fracture fragment and tendon repair (12 weeks) | |||
|} | |||
==See Also== | ==See Also== | ||
*[[Hand | *[[Hand and finger diagnoses]] | ||
== | ==References== | ||
<references/> | |||
[[Category: | [[Category:Orthopedics]] | ||
[[Category:Sports Medicine]] | |||
Latest revision as of 16:31, 18 October 2019
Background
- Avulsion of flexor tendon from distal phalanx
- Occurs from forced extension of flexed DIP (historically from grabbing someone's jersey with the tip of a finger)
Clinical Features
- Inability to actively flex DIP joint
- Full passive ROM is maintained
Differential Diagnosis
Hand and finger injuries
- Distal finger
- Other finger/thumb
- Boutonniere deformity
- Mallet finger
- Jammed finger
- Jersey finger
- Trigger finger
- Ring avulsion injury
- De Quervain tenosynovitis
- Infiltrative tenosynovitis
- Metacarpophalangeal ulnar ligament rupture (Gamekeeper's thumb)
- Hand
- Wrist
- Drummer's wrist
- Ganglion cyst
- Lunotriquetral ligament instability
- Scaphoid fracture
- Extensor digitorum tenosynovitis
- Compressive neuropathy ("bracelet syndrome")
- Intersection syndrome
- Snapping Extensor Carpi Ulnaris
- Vaughn Jackson syndrome
- General
Evaluation
- Clinical diagnosis
- Ultrasound can differentiate between partial and complete rupture[1]
Management
- Finger splint in slight flexion at DIP
- Early follow-up (24-48 hours) with hand specialist - surgery is required for all Jersey finger injuries
Disposition
- Discharge
Specialty Care
- Based on Leddy and Packer Classification[2]
| Class | Description | Treatment |
|---|---|---|
| I | Vincula ruptured with tendon retraction to palm | Primary tendon repair within 10 days |
| II | Vincula intact with tendon retraction to proximal interphalangeal joint | Primary tendon repair within 10 days (but may be delayed) |
| III | Fracture fragment retains tendon at distal interphalangeal joint | Repair of fracture fragment (6 weeks) |
| IV | Fracture fragment has tendon avulsed off and retracted | Repair of fracture fragment and tendon repair (12 weeks) |