Distal phalangeal volar base fractures are consistent with jersey finger. The mechanism of injury is hyperextension, such as pulling on the jersey of a football opponent running away from you, or in this case a rope or leash. Jersey finger represents an avulsion-type injury involving the flexor digitorum profundus, at its distal osseous insertion and/or more proximally in the tendon itself.

The patient was initially managed conservatively, with buddy taping and then occupational therapy. MRI was obtained to assess whether the tendon was still attached to the osseous fragment (Leddy and Packer type III vs. type IV), which affects surgical planning. The middle/long finger was a Leddy IV injury ("double avulsion" with retraction of tendon from fracture fragment) and the ring finger was a Leddy III injury (large avulsion fracture fragment, which cannot retract beyond the A4 pulley of the middle phalanx).

Tendon repair/reconstruction was offered but declined. The patient developed a mild boutonniere deformity of the long finger, which was bothersome and treated with fusion of the distal interphalangeal joint.