Concurrent Ring Finger Middle Phalanx Fracture and Jersey Finger in a Rugby Player

Area of Science:

• Orthopedics
• Sports Medicine
• Hand Surgery

Background:

• Flexor digitorum profundus (FDP) tendon avulsions and phalanx fractures are common in rugby.
• Concurrent injuries of both FDP avulsion and phalanx fracture in the same finger are rare and previously undescribed.

Observation:

• A 20-year-old female rugby player presented with a comminuted, mildly displaced middle phalanx fracture of the right ring finger.
• Initial non-operative management was chosen, but persistent inability to flex the distal interphalangeal joint (DIPJ) was noted.
• Ultrasound was inconclusive, but MRI confirmed an FDP tendon avulsion from the distal phalanx, indicative of a jersey finger injury.

Findings:

• A concurrent injury of a middle phalanx fracture and a jersey finger (FDP tendon avulsion) was diagnosed in a rugby player.
• The diagnosis was confirmed via MRI after initial clinical suspicion and inconclusive ultrasound.
• Surgical intervention (open repair) was required for the FDP tendon avulsion.

Implications:

• This case underscores the necessity of a high index of suspicion for coexisting injuries in athletes presenting with finger trauma.
• A comprehensive physical examination is crucial for identifying combined injuries, such as simultaneous FDP avulsion and phalangeal fractures.
• Early and accurate diagnosis through advanced imaging like MRI can lead to appropriate surgical management and improved patient outcomes.