Jersey finger is a condition where the end of the finger is upward and does not straighten. It occurs when the flexor tendon on the front of the finger is damaged. The finger joint is a hinge-joint that allows bending and straightening of the fingers. Each finger is composed of 3 phalanges (finger bones), joined by 2 interphalangeal joints (IP joints). The joint near the base of the finger is called the proximal IP joint or PIP joint, and the joint near the tip of the finger is called the distal IP joint or DIP joint.
Jersey finger occurs from sports activities causing a “jammed” finger or from excessive stress on the finger such as with a crushing injury. The injury causes either rupture of the flexor tendon without a bone fracture or rupture with a small or large bone fracture.
Generally, Jersey finger cannot be treated non-surgically and surgery is recommended.
If left untreated, Jersey finger can develop into a finger joint deformity referred to as a Boutonniere deformity.
Causes
Jersey finger occurs due to sports activities (such as baseball) or other activities that cause a direct and forceful impact on the fingers.
Signs and Symptoms
The main symptom of Jersey finger is drooping of the finger upward at the distal joint, pain and swelling around the area and limited active range of motion at the joint.
Diagnosis
The diagnosis of Jersey finger involves a physical examination and obtaining an X-ray of the injured finger. In some cases, other imaging techniques such as MRI scan may be recommended.
Treatment
Jersey fingers cannot be treated non-surgically. Dr Bala may recommend surgery which involves repairing the torn tendon. If the jersey finger involves a fracture of the bone fragment, then it can be stabilised and fixed using screws alone or a plate. Otherwise, the tendon is fixed back to bone and the volar plate using a bone anchor or with a suture attached to a button over the nail. Rarely after the procedure the joint may still be subluxated or unstable and may require additional procedures like a wire across the joint to align and stabilize it.
In chronic untreated injuries Dr Bala may advise fusion of the fingertip joint to improve function and cosmesis. This is done through the back surface of the finger just above the nail. The cartilage of the joint is removed and bone graft from the back of the wrist is put into the joint. The joint is stabilised in the neutral position with a headless titanium screw under x-ray guidance. An aluminium splint is applied for 4- 6 weeks after surgery to aid fusion of the joint.
Post-operative care
After jersey finger surgery, the patient is recommended for physiotherapy for flexibility and strengthening exercises.
Risks and complications
The common risks and complications associated with mallet finger surgery, include:
- Avascular necrosis (bone death from lack of blood supply)
- Infection
- Stiffness
- Nail-bed damage
- Chronic tenderness
Dr Bala uses special magnification loupes to visualize and protect individual blood vessels and nerves in this region to minimize complications.