Rugby Jersey Finger ( FDP)

Mr Mike Hayton
FRCS(Trauma and Orth) FFSEM (UK)
Consultant Orthopaedic Hand Surgeon

Other common names

 - Rugby jersey finger
 - FDP rupture zone 1

Who does it affect?

This is very common in rugby players. However, it can occur in other individuals who catch one of their fingers in a slightly bent-over position, and the finger is forcibly stretched out.

Why does it occur?

When the rugby player is grasping an opponent's jersey the finger tip is bent in a hooked position. His opponent breaks the tackle and, as a result, causes a forcible, bending back of the finger, rupturing the tendon as it inserts onto the end of the finger.

Symptoms

The individual notices discomfort on the front of the tip of the finger and an inability to bend the end finger joint.

Clinical examination

This reveals an inability to flex (bend the fingertip). There will be localised tenderness and bruising at the fingertip, and often also in the palm.

Investigations

Plain x-rays are performed, to see whether the tendon has pulled a piece of bone off with it. Ultrasound scans are a good dynamic, non-invasive technique, to visualise the tendon ends. MRI scan is often performed, again to visualise the tendon ends.

Non-operative treatment

Occasionally, individuals who suffer with this condition do not wish to have treatment. This will render them with a floppy fingertip and an inability to flex the fingertip. If this causes any problem in the future they may be offered a fusion of the end finger joint or a tendon reconstruction.

Operative treatment

Surgery needs to be performed within the first seven to ten days for optimum results. Under general anaesthetic the ruptured tendon is reattached to its original site.

If you wish to watch a video of the actual surgery please click here

Post-operative rehabilitation

This involves approximately six weeks in a splint. The splint is placed on the back of the hand, with the fingers in a slightly bent-over position. This prevents undue stress on the underlying tendon repair. Patients are encouraged to bend their fingertips but are discouraged from fully straightening them, which may pull off the healing tendon. Generally speaking, the splint is worn for six weeks, and a return to contact sport is in the region of three months.

Return to activities of daily living

The splint is worn constantly for 6 weeks.
Return to contact sports is around 12 weeks although each case is different.

 

Complications

Re-rupture about 10%
Bending over of the finger ( unable to fully straighetn the finger) 5%

Please click below for a video clip of this injury pre and post op ( no operative videos shown)

Please click below for a video clip of this injury pre and post op ( no operative videos shown)

Pre- operative

6 weeks post-operative