A review of mallet finger and jersey finger injuries in the athlete.

PURPOSE OF REVIEW: The purposes of this review are to discuss the diagnosis and management of mallet and jersey finger injuries in athletes and to highlight how treatment impacts return to play. RECENT FINDINGS: Mallet finger: although numerous non-operative and operative techniques have been described, there continues to be little consensus regarding the optimal procedure. Jersey finger: ultrasound appears to be a cost-effective imaging modality that may be useful for preoperative planning. Wide-awake surgery offers optimal intraoperative assessment of the tendon repair. Tendon repair with volar plate augmentation has been shown to improve the strength of the repair in the laboratory, and early clinical results are encouraging. Most mallet finger injuries will heal with non-operative treatment over a period of 8-12 weeks, even when treatment is delayed up to 3-4 months. An acute diagnosis of jersey finger requires surgical treatment and generally means 8-12 weeks of inability to compete in most contact sports.

Hand Surgeon Reporting of Tendon Rupture Following Distal Radius Volar Plating.

Background: Volar plate fixation with locked screws has become the preferred treatment of displaced distal radius fractures that cannot be managed nonoperatively. This treatment, however, is not without complication. The purpose of this study was to determine what percentage of hand surgeons, over a 12-month period, have experienced a tendon complication when using volar plates for the treatment of distal radius fractures. Methods: A total of 3022 hand surgeons were e-mailed a link to an online questionnaire regarding their observation and treatment of tendon injuries associated with volar plating of distal radius fractures. Responses were reported using descriptive statistics. Results: Of the 596 (20%) respondents, 199 (33%) surgeons reported encountering at least one flexor tendon injury after distal radius volar plating over the past year of practice. The flexor pollicis longus was the most commonly reported tendon injury (254, 75%). Palmaris longus grafting (118, 37%) and tendon transfer (114, 36%) were the most often reported treatments following this complication. A total of 216 respondents (36%) also encountered 324 cases of extensor tendon rupture after volar plating of distal radius fractures, with tendon transfer (88%) being the preferred treatment option. Conclusions: Both flexor and extensor tendon ruptures can be seen after volar plating of distal radius fractures. Surgeons should be aware of these complications. Critical assessment of hardware position at the time of index procedure is recommended to avoid complications. Long-term studies are needed to standardize approaches to managing tendon rupture following volar plating of distal radius fractures.