A Jersey finger is a traumatic rupture of the flexor digitorum profundus (FDP) tendon, which tears away from its attachment on the fingertip bone. This injury often occurs in sports like football or rugby when a player grabs an opponent’s jersey and their finger is forcefully extended as the opponent pulls away. The ring finger is the most commonly affected digit, resulting in an inability to bend the tip of the finger, accompanied by pain and swelling.
Diagnosis and Pre-Surgical Assessment
Identifying a Jersey finger begins with a physical examination. The most telling sign is the inability to actively bend the final joint of the affected finger, causing the fingertip to remain straight. A doctor may hold the middle joint straight to isolate the movement of the fingertip to confirm a rupture.
To assess the injury’s severity, imaging tests are used. X-rays are ordered to determine if a piece of bone was pulled away with the tendon. An MRI or ultrasound may also be used to visualize the torn tendon and pinpoint how far it has retracted into the finger or palm.
The extent of the tendon’s retraction is a primary factor in classifying the injury’s severity. If the tendon has retracted into the palm, its blood supply can be disrupted, which can affect healing and surgical planning.
The Surgical Repair Procedure
Surgical intervention is the standard treatment for a complete Jersey finger tear. The goal is to reattach the torn flexor tendon to the bone at the fingertip, known as the distal phalanx. The procedure is performed on an outpatient basis, meaning the patient can go home the same day.
The operation begins with the surgeon making an incision in the finger or palm to locate the end of the retracted tendon. The tendon is then guided back through its sheath to its original position at the tip of the finger.
To secure the tendon, the surgeon reattaches it directly to the bone. One common technique involves passing sutures through the tendon and small holes drilled into the bone, which are then tied over a button on the fingernail. In other cases, small metal or plastic devices called bone anchors may be used to affix the tendon to the bone. If a bone fragment was also pulled away, it may be fixed with pins or screws.
Post-Surgery Recovery and Rehabilitation
Immediately following the operation, the hand is placed in a protective splint. This splint holds the wrist and fingers in a bent position to reduce tension on the newly repaired tendon and is worn for several weeks.
Rehabilitation with a certified hand therapist begins soon after surgery. The initial phase involves passive motion exercises, where the therapist gently moves the finger to prevent it from becoming stiff or scarred down. This early, controlled movement protects the repair while encouraging flexibility.
As healing progresses, the patient transitions to active motion exercises, beginning to move the finger on their own. The final stage involves strengthening exercises to rebuild grip strength and fine motor control. Full recovery can take several months before a return to strenuous activities is permitted.
Factors Influencing Repair Success
The timing of surgical intervention is a primary factor in the outcome. Surgery performed within the first 7 to 10 days after the injury yields more successful results. Delays can lead to further retraction of the tendon, muscle shortening, and scar tissue formation, which complicates the repair and can compromise the final range of motion.
The initial severity of the injury also plays a role in the success of the repair. Tendons that have retracted a shorter distance are easier to repair and have a better prognosis because their blood supply is less likely to be disrupted. Injuries where the tendon has pulled into the palm present a greater surgical challenge.
Patient adherence to the post-operative rehabilitation program is also needed for a successful outcome. Too much activity too soon can risk re-rupturing the tendon, while insufficient movement can lead to permanent stiffness.