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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.
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It is characterised 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 visualisation of the location of the end of tendons which will affect the surgical classification and management of the patient 4,5.
Treatment and prognosis
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 orthopaedic hand surgeon; tendon retraction and time from injury are key 1
unstable DIP joint
development of secondary osteoarthritic changes
DIP flexion contracture or quadrigia
- 1. Mark D. Miller, Jennifer Adele Hart, John M. MacKnight. Essential Orthopaedics. (2010) ISBN: 9781416054733 - Google Books
- 2. Manske P & Lesker P. Avulsion of the Ring Finger Flexor Digitorum Profundus Tendon: An Experimental Study. Hand. 1978;10(1):52-5. doi:10.1016/s0072-968x(78)80025-4 - Pubmed
- 3. Martin L. Lazarus. Imaging of Athletic Injuries of the Upper Extremity. (2013) ISBN: 9781455748884 - Google Books
- 4. Borut Marincek, Robert F. Dondelinger. Emergency Radiology. (2006) ISBN: 9783540262275 - Google Books
- 5. Clavero J, Alomar X, Monill J et al. MR Imaging of Ligament and Tendon Injuries of the Fingers. Radiographics. 2002;22(2):237-56. doi:10.1148/radiographics.22.2.g02mr11237 - Pubmed
- 6. Wieschhoff G, Sheehan S, Wortman J et al. Traumatic Finger Injuries: What the Orthopedic Surgeon Wants to Know. Radiographics. 2016;36(4):1106-28. doi:10.1148/rg.2016150216 - Pubmed