Anatomy
The five fingers consist of 14 small, tubular finger bones (phalanges). On top of the fingers (back of the hand, dorsally) run the extensor tendons that attach to the outermost finger bone (distal phalanx).
Cause of the problem
A direct blow to the tip of a stretched finger (football goalies, handball, volleyball and basketball players) can rupture the extensor tendon at the attachment on the outer joint of the finger (also known as a ‘baseball finger’ injury). Often the bone on which the extensor tendon attaches is ruptured, but the lesion can occur in the tendon itself
Symptoms
There is stretching pain and stretch defect of the outer joint of the finger.
Examination
The diagnosis is made on clinical examination, where it is characteristic that the outer joint of the finger is slightly bent and cannot be actively stretched. In case of a stretching defect after direct trauma, an X-ray should be taken to ensure correct diagnosis and treatment.
Treatment
Bandage the finger with the outer piece fully stretched. Usually a small plastic fingertip (Oakley splint) is used. The plastic bandage should be used for at least 6 weeks. The vast majority can be treated this way. If there has been a major bone tear involving more than 1/3 of the joint surface or with displacement of the torn bone, surgery may be indicated (Handoll HH, Vaghela MV. 2004).
Rehabilitation
Usually, you can immediately start cardio training in the form of cycling and running, as well as rehabilitation according to the guidelines under rehabilitation in general. Handball, volleyball, basketball, etc. should be avoided for a few weeks after splint removal.
Bandage
Taping the injured finger together with the neighbouring finger will often relieve the injury after the bandage is removed, see taping
Complications
In the vast majority of cases, tendon ruptures heal without complications. In some cases, a small stretching defect remains, which increases the risk of re-injury during handball, volleyball, etc., so continued tape treatment may be indicated.
