Jersey finger (also called Rugby finger or Sweater finger) describes a type of injury where there is avulsion of the flexor digitorum profundus (FDP) at the base of the distal interphalangeal joint (DIP) 1.
Most commonly affects the 4th digit as the FDP insertion into the ring finger is anatomically weaker than the middle finger 2.
It classically occurs during certain sports resulting from sudden hyperextension of actively flexed finger (e.g., grabbing opponent's jersey during rugby or American football.)
It is characterised by inability to flex the finger at the distal interphalageal (DIP) joint. There is slight extension at this joint. There is pain and tenderness over the volar distal finger.1
Radiographs can often be normal 3. If there is a bony avulsion, plain film would classically show a triangular avulsion fragment at the flexor aspect of the distal phalanx at the distal interphalangeal (DIP) joint and overlying soft tissue swelling.
Disruption of flexor digitorum profundus (FDP) at volar base of distal phalanx ± avulsion fragment. MRI also allows visualisation of the location of the end of tendons which will affect the surgical classification and management of the patient 4,5.
- unstable DIP joint
- development of secondary osteoarthritic changes
- DIP flexion contracture or quadrigia
Treatment and prognosis
- conservative for partial tear (i.e. splinting, NSAID's, physical therapy)
- surgical intervention: all complete flexor tendon injuries should be surgically repaired or at least referred to an orthopaedic hand surgeon; tendon retraction and time from injury are key 1
Wrist and hand fractures
- wrist and hand fractures (Amsterdam wrist rules)
- distal radial fracture (Frykman classification)
- distal ulna fractures
- fracture dislocations of the radius and ulna
- carpal fractures
- metacarpal fractures
- phalanx fractures
- 1. Miller MD, PA-C JHMPAS, MacKnight JM. Essential Orthopaedics. Saunders. (2009) ISBN:1416054731. Read it at Google Books - Find it at Amazon
- 2. Manske PR, Lesker PA. Avulsion of the ring finger flexor digitorum profundus tendon: an experimental study. Hand. 1979;10 (1): 52-5. Pubmed citation
- 3. Lazarus ML. Upper Extremity. An Issue of Radiologic Clinics of North America. Pg 19 Elsevier. (2013) ISBN:1455748889. Read it at Google Books - Find it at Amazon
- 4. Emergency Radiology: Imaging and Intervention. Pg 272 Springer. ISBN:354026227X. Read it at Google Books - Find it at Amazon
- 5. Clavero JA, Alomar X, Monill JM et-al. MR imaging of ligament and tendon injuries of the fingers. Radiographics. 2002;22 (2): 237-56. Radiographics (full text) - Pubmed citation