From the Guidelines
Jersey finger is a specific type of injury to the flexor digitorum profundus tendon, characterized by an avulsion injury from its insertion at the base of the distal phalanx, which can be accurately diagnosed and evaluated using MRI, as reported by Rubin et al with a sensitivity of 92% and specificity of 100% in cadavers 1.
Diagnosis and Evaluation
The diagnosis of jersey finger involves a combination of clinical examination and imaging studies. MRI is the preferred imaging modality for evaluating tendon injuries, including jersey finger, as it allows for direct visualization of the tendon and associated injuries, such as pulley injuries, with high sensitivity and specificity 1.
Clinical Presentation
Patients with jersey finger typically present with sudden pain, inability to bend the fingertip independently, and sometimes swelling at the palm side of the affected finger. This injury usually occurs when a player grabs another person's jersey during sports and the finger is forcibly extended while actively flexed.
Treatment
Treatment of jersey finger depends on the severity and timing of the injury, with surgical repair being the standard approach, ideally within 7-10 days of injury for best outcomes, as delayed repair can lead to retraction of the tendon into the palm and development of scarring that prevents proper healing. Surgery involves reattaching the tendon to bone using sutures or anchors, followed by a protected rehabilitation protocol lasting 8-12 weeks 1.
Importance of Prompt Medical Attention
Prompt medical attention is crucial in the management of jersey finger, as delayed treatment can result in permanent loss of the ability to bend the fingertip, highlighting the need for early diagnosis and intervention to optimize outcomes 1.
From the Research
Definition and Classification of Jersey Finger
- Jersey finger, also known as avulsion of the flexor digitorum profundus (FDP) tendon, is a type of injury commonly seen in contact sports players such as rugby and football 2, 3, 4.
- The Leddy and Packer classification system categorizes jersey finger injuries into three types based on the level of retraction of the tendon, with a subsequent addition of Type IV by Smith, where the tendon is separated from the avulsed bony fragment 2, 4, 5.
Causes and Diagnosis
- Jersey finger injuries can occur in both athletes and non-athletes, and may not always be initially diagnosed 3.
- Early diagnosis and repair are essential to regain optimum return of function, with delayed diagnosis often resulting in finger stiffness and requiring occupational therapy to maximize finger range of motion 3.
- The diagnosis of jersey finger injuries can be made through clinical evaluation and imaging studies, with the goal of prompt treatment to achieve good outcomes 3, 4.
Treatment Options
- Surgical treatment is often necessary for jersey finger injuries, with various techniques available, including open reduction and K-wire fixation, anchor and pull-out techniques, and tendon grafting 2, 4, 6, 5.
- The choice of treatment depends on the type and severity of the injury, as well as the patient's overall health and activity level 6, 5.
- New techniques, such as mini-open one-stage flexor digitorum profundus tendon graft under WALANT with ultrasound assistance, have been developed to treat late presentations of jersey finger injuries 6.
Outcomes and Complications
- The outcomes of surgical treatment for jersey finger injuries can vary, with some patients achieving excellent or good results, while others may experience poor outcomes or complications 5.
- Complications, such as finger stiffness and decreased range of motion, can occur, but rapid diagnosis and treatment can help minimize these risks and restore full range of motion 3, 5.