Jersey finger

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

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)

See Also

References

  1. De Gautard G, et al. Sonography of jersey finger. J Ultrasound Med. 2009; 28(3):389-392.
  2. 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.