Jersey finger

Last revised by Henry Knipe on 4 Mar 2023

Jersey finger (also called rugby finger or sweater finger) describes a type of injury where there is avulsion of the flexor digitorum profundus (FDP) from the volar aspect of the distal phalanx base 1. It classically occurs during certain sports resulting from sudden hyperextension of an actively flexed finger (e.g. grabbing an opponent's jersey during rugby or American football.)

It most commonly affects the 4th digit because the FDP insertion into the ring finger is anatomically weaker than the middle finger 2.

It is characterized by an inability to flex the finger at the distal interphalangeal (DIP) joint. There is a 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, a triangular avulsion fragment at the volar aspect of the distal phalanx base and overlying soft tissue swelling may be seen.

Disruption of flexor digitorum profundus (FDP) at the volar base of distal phalanx ± avulsion fragment. MRI also allows visualization of the location of the end of tendons which will affect the surgical classification and management of the patient 4,5.

  • conservative for partial tear (i.e. splinting, NSAIDs, physical therapy)

  • surgical intervention: all complete flexor tendon injuries should be surgically repaired or at least referred to an orthopedic hand surgeon; tendon retraction and time from injury are key 1

  • unstable DIP joint

  • development of secondary osteoarthritic changes

  • DIP flexion contracture or quadrigia

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