Finger Injuries in Football and Rugby

Abstract

Football and rugby athletes are at increased risk of finger injuries given the full-contact nature of these sports. Some players may return to play early with protective taping, splinting, and casting. Others require a longer rehabilitation period and prolonged time away from the field. The treating hand surgeon must weigh the benefits of early return to play for the current season and future playing career against the risks of reinjury and long-term morbidity, including post-traumatic arthritis and decreased range of motion and strength. Each player must be comprehensively assessed and managed with an individualized treatment plan.

Keywords: Football finger injuries; Jersey finger; Mallet finger; Return to play; Rugby finger injuries.

Fig. 1

(A) PA and (B) lateral radiographs showing two buried, percutaneously placed K wires used to treat a mallet finger. The DIP joint is held in extension for 6 weeks. If the player returns to play with the K wires in place, a DIP extension splint is recommended for additional protection.

Fig. 1

(A) PA and (B) lateral radiographs showing two buried, percutaneously placed K wires used to treat a mallet finger. The DIP joint is held in extension for 6 weeks. If the player returns to play with the K wires in place, a DIP extension splint is recommended for additional protection.

Fig. 2

A jersey finger can be repaired using a pull-through suture button technique. (A) The distally avulsed FDP tendon is reattached to its insertion on the volar base of the distal phalanx using a non-absorbable suture. Two Keith needles are drilled through the distal phalanx obliquely to pass the suture tails from the volar distal phalanx base to the dorsal distal phalanx, through the nail distal to the germinal matrix. (B) The pulleys are maintained. (C) The suture is tied over a button dorsally and remains in place for 6 weeks following repair of a jersey finger. Early hand therapy, with the button in place, is critical to allow tendon gilding to optimize the range of motion of the injured finger.

Fig. 2

A jersey finger can be repaired using a pull-through suture button technique. (A) The distally avulsed FDP tendon is reattached to its insertion on the volar base of the distal phalanx using a non-absorbable suture. Two Keith needles are drilled through the distal phalanx obliquely to pass the suture tails from the volar distal phalanx base to the dorsal distal phalanx, through the nail distal to the germinal matrix. (B) The pulleys are maintained. (C) The suture is tied over a button dorsally and remains in place for 6 weeks following repair of a jersey finger. Early hand therapy, with the button in place, is critical to allow tendon gilding to optimize the range of motion of the injured finger.

Fig. 2

A jersey finger can be repaired using a pull-through suture button technique. (A) The distally avulsed FDP tendon is reattached to its insertion on the volar base of the distal phalanx using a non-absorbable suture. Two Keith needles are drilled through the distal phalanx obliquely to pass the suture tails from the volar distal phalanx base to the dorsal distal phalanx, through the nail distal to the germinal matrix. (B) The pulleys are maintained. (C) The suture is tied over a button dorsally and remains in place for 6 weeks following repair of a jersey finger. Early hand therapy, with the button in place, is critical to allow tendon gilding to optimize the range of motion of the injured finger.

Fig. 3

Individual finger taping can be used to allow early return to play for collateral ligament injuries. From Singletary S, Geissler WB. Bracing and Rehabilitation for Wrist and Hand Injuries in Collegiate Athletes. Hand Clin 2009;25(3): 447; with permission.

Fig. 4

Suture anchor repair can be used to treat complete tears of the thumb MCP UCL. The ligament is more commonly avulsed from its distal insertion on the base of the proximal phalanx than from its origin on the metacarpal head.

Fig. 5

A percutaneously placed headless compression screw can be used for fixation of unicondylar phalangeal fractures. This minimally invasive technique minimizes tissue trauma and is preferred for athletes. (A) Preoperative and (B) postoperative radiographs are shown for an ulnar unicondylar fracture of the proximal phalanx of a thumb.

Fig. 5

A percutaneously placed headless compression screw can be used for fixation of unicondylar phalangeal fractures. This minimally invasive technique minimizes tissue trauma and is preferred for athletes. (A) Preoperative and (B) postoperative radiographs are shown for an ulnar unicondylar fracture of the proximal phalanx of a thumb.

Fig. 6

A closed-cell polyurethane padded club cast can be worn to protect a hand injury during football practices and games. From Geissler WB. Operative fixation of metacarpal and phalangeal fractures in athletes. Hand Clin 2009;25(3):417; with permission.