February 2 was a big day for football fans across the country. The Kansas City Chiefs defeated the San Francisco 49ers in the Super Bowl in one of the more entertaining games over the past decade. Before the Super Bowl an even bigger game occurred for Ascend Hand Therapy’s owners, David and Oliver (both LSU alumni), when LSU defeated Clemson for the NCAA National Championship. Fortunately, one of the things we did not see in these games is an injury known as a jersey finger. Jersey finger injuries most often occur in sports such as football and rugby. What is a jersey finger?
A jersey finger injury occurs when one of the deep flexor tendons of the hand is avulsed or ruptured at the level of the distal interphalangeal (DIP) joint or the tip of the finger. The injury commonly occurs when the finger is caught in another player’s jersey causing an excessive force to go through the deep flexor tendon known as the flexor digitorum profundus (FDP). A jersey finger can have different degrees of injury. According to hand411.com, there are 4 different types:
- Type I — the tendon is retracted completely into the palm and the proximal interphalangeal (PIP) joint can be fully flexed. Surgery is recommended within 7-10 days, otherwise the tendon is likely to be shortened, which may cause complications with range of motion later.
- Type II — the tendon is retracted back to the PIP joint and impedes flexion of the joint. Surgery is recommended as soon as possible, but may also be possible at a later time.
- Type IIIa — an avulsion fracture is associated and the fragment becomes caught in the A4 pulley. Surgery is recommended as soon as possible, but may also be possible at a later time.
- Type IIIb — a distal phalanx fracture is associated and the tendon is avulsed from the fractured bone. The first priority is open reduction and internal fixation of the fracture. Then within 7-10 days, the tendon is repaired to prevent shortening.
- Type IV — a comminuted intra-articular fracture of the distal phalanx
To put it in layman’s terms, the tendon itself can rupture or the portion of bone where the tendon inserts can be avulsed resulting in a jersey finger. In either case, the ability to bend or flex the tip of the finger is affected. If the tendon is only partially torn, a patient may only need a splint to immobilize the joint giving the finger time to heal itself. If the tendon is fully torn or the bone is avulsed, then surgical intervention is required. The hand surgeon will repair the bone and/or tendon as needed. Following surgery, hand therapy is required to help regain motion and function of the affected finger. Patients are placed in a blocking splint soon after surgery and given specific exercises to do. The splint and the exercises allow the tendon to move in a safe range, but do not put overstress on the repair as too much stress on the repair site can lead to a secondary rupture.
The therapists here at Ascend Hand Therapy are well trained to treat injuries like this one and any other injury that may affect someone’s hand, wrist, elbow, or shoulder. We have treated professional athletes and weekend warriors alike. We may have only been spectators of the Super Bowl and NCAA National Championship, but we are the real champions of all your hand therapy needs! Geaux Tigers!