Treatment of a Jersey Finger
Symptoms of a Jersey Finger
An athlete who has sustained a jersey finger will be unable to bend the finger down into the palm of the hand. This is usually an obvious injury as the fingers normally rest in a partly flexed position. If you set your hand on the table at rest, the normal posture of the hand is a position similar to if you were to be holding a glass. The reason is that the tendons flexing (bending) and extending (straightening) your finger are balanced. Therefore the finger assumes this partly bent position. When the flexor tendon is injured, the finger will straighten excessively at rest. At rest, patients with a jersey finger will notice one finger straightened out unexpectedly.
Treatment of a Jersey Finger
As mentioned previously, the injured tendon snaps back all the way to the base of the finger, or perhaps even further. Therefore, if the injury is to be corrected, a surgical procedure is necessary. The surgery performed must accomplish the following general steps:
•Locate the tendon at the base of the finger or in the palm
•Thread the tendon through the finger in the proper position
•Securely reattach the tendon to the tip of the finger
The final task is the most difficult, as early motion of the finger is critical for therapy. Therefore, the attachment must be sufficiently secure to tolerate this movement. Typically, the tendon is reattached to the bone by drilling small holes in the bone. Sutures are pulled through the bone, then through the fingernail, and tied on the back of the finger. The sutures are actually tied over a button that looks much like a shirt button. An alternative is to use a metal anchor to hold the sutures in the bone.
Jersey Finger Rehabilitation
After surgery, patients will work with a hand therapist to regain the motion of the finger. Flexor tendons have a tendency to become very stiff and scarred, and therefore working with a therapist is important. Even if appropriate hand therapy is done, stiffness is not an unusual complication of jersey finger surgery. Early on in your therapy, you will be instructed on specific methods to move the tendons without pulling on the site of the repair. Return to tackling sports is usually delayed until complete healing has occurred, often 4-6 months.
Jersey Finger
Our hands are the tools with which we manipulate our environment. They define us in our occupations, entertain us with our hobbies, and touch the people close to us. With their constant use, our hands are bound to have a variety of cuts, bumps, and bruises. Most of these heal without need for medical attention. However, there are some injuries, initially perceived as minor, which can become severe problems if left untreated:
- Mallet finger: This is a problem when the tip of the finger gets bent suddenly. The tendon that straightens the finger tears off the bone or it may take a small piece of bone with it. At first, the finger may be only slightly bent at the tip, but this often worsens over time. The tendon then shortens and pulls on some additional fibers called the lateral bands. These bands can tighten at the middle joint in the finger and keep it from bending. This is called a swan neck deformity and it can severely limit hand function. Prompt treatment, keeping the fingertip fully straight for several weeks, can prevent developing a swan neck deformity.
- Jerseyfinger: This is a problem when the grasping hand gets pulled suddenly and the tip of the finger is forcibly extended. Similar to a mallet finger, the flexor tendon ruptures off the bone or may take a fragment of bone with it. This often neglected injury causes little difficulty at first-just loss of bend at the tip of the finger. However, over time, the tendon can scar and contract. Since all 4 fingers share a common muscle, the scarring and shortening can limit motion of the other fingers causing weakened grip. Treated with early surgery and proper post-operative rehabilitation, these fingers can have near normal function.
- Boutonniere deformity: This is a problem that can result from a “jammed” finger or dislocation. The middle knuckle can be injured by an impact to the tip or hyperextension, often involving a ball. Most fingers do well with minimal splinting and early motion. However, if the extensor tendon tears off the middle bone segment, the lateral bands can tighten to bend the middle knuckle and hyperextend the fingertip. This deformity can become very tight so that the finger no longer moves. Early splinting and hand therapy can prevent progressive deformity.
- Nerve injury: A simple cut should not cause numbness for more than a brief period related to swelling and shock to the nerve. Within a couple of days, feeling should return. If numbness is present, particularly if it is the area just past the wound, it should be evaluated. While the numbness may not be bothersome nor limiting, a painful ball of nerve fibers, called a neuroma, can develop. Nerves heal better if repaired early, while the cut is fresh.