From the Guidelines
Surgical repair is the recommended treatment for a Jersey finger injury, particularly for complete tendon ruptures, to reattach the flexor digitorum profundus tendon to the distal phalanx and restore finger function. The initial management of a Jersey finger injury involves immobilizing the finger with a splint, and using ice, elevation, and anti-inflammatory medications like ibuprofen (400-600mg every 6-8 hours) or naproxen (250-500mg twice daily) to manage pain and swelling 1.
Key Considerations
- Immobilization with a splint is crucial in the initial stages to prevent further injury and promote healing.
- Surgical intervention is usually necessary within 7-10 days of injury to reattach the tendon, as delayed treatment can lead to permanent loss of finger flexion, decreased grip strength, and chronic pain.
- Following surgery, a structured rehabilitation program under the guidance of a hand therapist is essential for optimal recovery, including progressive passive and active range-of-motion exercises, followed by strengthening exercises over 8-12 weeks 1.
Diagnostic Imaging
MRI is commonly used to evaluate the level of tendon retraction, the quality of the tendon stump, and associated injuries, including pulley injuries, in patients with Jersey finger 1. It allows for the assessment of pulley system lesions and can accurately depict the pulley system, particularly the A2 and A4 pulleys.
Rehabilitation and Outcome
Complete recovery may take 3-6 months, and even with optimal treatment, some patients may experience residual stiffness or slightly decreased strength in the affected finger. However, prompt surgical intervention and a well-structured rehabilitation program can significantly improve outcomes and reduce the risk of long-term morbidity and mortality related to the injury 1.
From the Research
Treatment Options for Jersey Finger Injury
- The treatment for a Jersey finger injury can vary depending on the severity and type of injury, with options including conservative treatment and surgery 2, 3, 4, 5.
- Conservative treatment may be recommended for minor displacements, with a study showing that 31 out of 44 patients with Jersey finger type V injuries had a good outcome with conservative treatment 2.
- Surgery may be necessary for more severe injuries, such as those with significant displacement or avulsion of the flexor digitorum profundus tendon, with a novel surgical technique described in a study 3.
- A case report also described the surgical approach for a Type IV Jersey finger injury, which involves a combination of a fracture of the volar base of the distal phalanx and avulsion of the flexor digitorum profundus tendon 4.
- Another study reported a case of a Type Vb flexor digitorum profundus tendon avulsion that was treated conservatively due to contraindications for surgery, with the patient achieving a nearly full active range of motion and excellent functional result after 6 weeks of treatment and 3 weeks of self-physiotherapy 5.
Comparison of Treatment Outcomes
- A study compared the outcomes of conservative treatment and surgery for Jersey finger injuries, finding that established surgical techniques for refixation did not show a satisfying outcome, suggesting the need for alternative surgical techniques 2.
- However, it's worth noting that the evidence for the treatment of Jersey finger injuries is limited, and more research is needed to determine the most effective treatment options.
Non-Surgical Treatment Options
- Non-steroidal anti-inflammatory drugs (NSAIDs) have been studied as a potential treatment option for trigger finger, a related condition, but the evidence suggests that NSAIDs may offer little to no benefit over glucocorticoid injection 6.
- The use of NSAIDs for Jersey finger injuries is not well established, and more research is needed to determine their effectiveness in treating this condition.