Classic history and presentation: The typically cited event is a player grabbing the jersey of the opponent. The patient will notice immediately that their finger is injured but may play through the injury.
The finger will rest in an extended position with an inability to flex the DIP joint. There may or may not be a palpable FDP tendon. Around 75% of cases involve the ring finger.
- Age – Jersey finger is usually seen in younger patients playing contact sports.
- Sex / gender – Predominantly male patients.
Grade / classification system: The disease is categorized according to the Leddy and Packer classification –
- Type I: FDP has completely retracted into the palm.
- Blood supply is maintained through the vinculum longus profundus (VLP). The vinculum brevis profundus (VBP) is lost with this type of injury.
- Type II: The FDP tendon is retracted to the proximal interphalangeal (PIP) joint. The VLP remains intact as a blood supply to the tendon, allowing for less urgency of repair.
- Type III: The FDP remains at the level of the DIP joint due to a large avulsion fracture.
- Type IV: Involves both an osseous avulsion fracture off of the distal phalanx and avulsion of the tendon, with retraction of the tendon into the palm.
- Type V: Bony avulsion in combination with an extraarticular or intraarticular fracture of the distal phalanx.