What is it:
Deformity of the finger characterised by inability to straighten the fingertip unless assisted by an external force.
Mechanism:
Often due to forced flexion at the furthest joint while the finger is actively extended eg ball hitting the fingertip.
There are two main ways this injury occurs – either the extensor tendon pulls away a small fragment of bone (avulsion fracture) or the extensor tendon itself ruptures.
Clinical presentation:
- Pain, tenderness and swelling on palpation at the distal joint of the finger if an avulsion fracture. Usually relatively painless when tendon ruptures.
- Inability to actively straighten the affected fingertip.
Management:
Non surgical:
- The creation of a custom thermoplastic splint that will hold fingertip into extension full time for ~6-8 weeks. Can gradually wean out of splint once tendon is strong enough to hold fingertip straight.
- Can usually resume sport with either taping fingertip into extension or wearing splint with tape to strap it on firmly.
- Gradual introduction of exercises to increase movement at the distal finger joint
Prognosis:
Good if treated prompt with splinting. Most individuals will regain their full strength and range of motion of their finger.
