Jersey Finger, also known as rugby finger, is a tendon injury that affects the finger. It involves the tearing of a tendon responsible for bending the fingertip. This injury can significantly impact the ability to perform fine motor tasks and grip objects. Prompt recognition and treatment are important for effective recovery and to prevent long-term complications.
The Injury Explained
Jersey Finger involves an avulsion (tearing away) of the flexor digitorum profundus (FDP) tendon from its attachment point on the distal phalanx, the bone at the fingertip. This tendon allows the fingertip to bend. The ring finger is most commonly affected in 75% of cases because it protrudes furthest when the hand is in a grasping position.
The injury happens when the FDP tendon is actively contracting to bend the finger, while the finger is forcefully straightened. For example, an athlete gripping an opponent’s jersey, as the opponent pulls away, violently extending the finger. This sudden, opposing force can cause the tendon to rupture from its bony insertion. While common in contact sports like football and rugby, it can also occur in activities such as rock climbing.
The severity of a Jersey Finger injury can vary, categorized by how far the torn tendon retracts and if bone is avulsed. Injuries range from partial tears to complete ruptures, sometimes with a small bone fragment attached. The extent of retraction impacts treatment urgency, as greater retraction can disrupt the tendon’s blood supply.
Recognizing and Diagnosing Jersey Finger
Individuals experiencing a Jersey Finger injury report immediate pain and may hear or feel a “popping” sensation. A distinguishing symptom is the inability to actively bend the fingertip, even though the finger might still bend at other joints. The injured fingertip may also appear swollen, tender to the touch, and bruised. Sometimes, a lump can be felt in the palm, indicating that the tendon has retracted.
Upon suspecting a Jersey Finger, applying ice to reduce swelling and elevating the hand can be beneficial. Seeking prompt medical attention is important for proper evaluation. Delaying assessment can complicate treatment and recovery.
A medical diagnosis begins with a physical examination of the hand. The doctor will assess the finger’s range of motion, checking for the ability to bend the fingertip in isolation. X-rays are used to determine if a piece of bone has avulsed with the tendon. While X-rays primarily show bone, an ultrasound or MRI may also be used to visualize soft tissues, assess tendon retraction, and identify any additional damage.
Treatment and Rehabilitation Approaches
Treatment for Jersey Finger depends on the injury’s severity, specifically, if the tendon is completely torn and its retraction distance. Non-surgical approaches are considered for rare cases of partial tears or avulsions with minimal tendon retraction. This involves immobilizing the finger with a splint and rest to allow the tendon to heal. Anti-inflammatory medications can help manage pain and swelling during this period.
Complete tears of the flexor digitorum profundus tendon require surgical intervention to reattach the tendon to the bone. The goal of surgery is to restore the finger’s ability to bend at the fingertip. Prompt repair, often within 7-10 days for severe injuries, is recommended to optimize outcomes and maintain tendon viability. Various surgical techniques exist, including methods that use sutures or small anchors to secure the tendon back to the bone.
Following treatment, whether surgical or non-surgical, immobilization of the finger is important to protect the healing tendon. This involves wearing a splint or cast for several weeks. The exact duration of immobilization can vary based on the injury’s extent and the type of repair performed.
Rehabilitation is an important phase in the recovery process, involving physical or occupational therapy. Therapists guide patients through a structured program of exercises to gradually restore range of motion, flexibility, and strength in the affected finger. These exercises are carefully progressed to prevent stiffness and promote proper tendon gliding. Full recovery can take several months, with athletes returning to sports within 8-12 weeks once full strength and range of motion are regained and pain has subsided. While successful treatment often leads to good outcomes, some individuals may experience residual stiffness or a slight reduction in their finger’s range of motion.