FLEXOR TENDON AVULSION INJURY
A torn flexor tendon avulsed from the fingertip during sport or trauma. Early surgical reattachment gives the best chance of full finger function — delay narrows that window significantly.
ABOUT THIS INJURY
Jersey finger is an avulsion injury of the flexor digitorum profundus (FDP) tendon — the tendon responsible for bending the fingertip. It occurs when the finger is forcibly straightened while actively flexed, typically during contact sport when a player grabs a jersey or is tackled. The ring finger is the most commonly affected. The result is a finger that can no longer actively bend at the tip joint.
Surgery is the definitive treatment. The torn tendon is surgically reattached to the bone at the fingertip through an incision in the palm and along the finger, using sutures or bone anchors. If non-surgical options such as splinting have failed, or if the injury is diagnosed promptly, early operative repair offers the best functional outcome.
Left untreated, a jersey finger will result in a permanently stiff finger with a severely limited range of motion — a significant handicap for anyone who relies on their hand for work or sport. Early diagnosis and timely surgery are the two factors that matter most in determining how well the finger recovers.
HOW SEVERE IS YOUR INJURY?
Jersey finger is classified by how far the tendon has retracted after avulsion. The grade determines both the urgency and the surgical technique required.
GRADE I — MOST URGENT
The FDP tendon has fully retracted into the palm, disrupting its blood supply. Without surgery within seven to ten days, the tendon becomes too scarred and shortened to be pulled back for direct repair. Grade I is the most time-sensitive jersey finger injury.
GRADE II
The tendon has retracted to the level of the proximal interphalangeal (PIP) joint where it is held by the vincula — the small blood-supply tethers. Its blood supply is preserved, allowing slightly more time for repair, but surgery is still urgently needed within a few weeks.
GRADE III — BONY AVULSION
A fragment of bone is pulled away with the tendon at the moment of injury and becomes visible on X-ray. The bone fragment is caught at the distal pulley, limiting retraction. Surgery reattaches the bone fragment and tendon back to the fingertip, often with a screw or pull-through wire technique.
PROCEDURE OVERVIEW
A clear summary of the procedure and what to expect on the day.
Surgery Time
Anaesthesia
Hospital Stay
Drains
Supporting Garment
The exact surgical approach — augmentation, reduction, lift or combination — is determined at consultation based on your individual anatomy and goals.
RECOVERY TIMELINE
Week 1
The tendon is reattached and a protective splint is fitted. Your first follow-up is at one week to check the wound and confirm the repair is healing as expected.
Weeks 2–4
Early protected range-of-motion exercises begin under strict physiotherapy supervision. The splint remains on. This phase is critical — premature unsupported movement risks re-rupture of the repaired tendon.
Weeks 4–8
Progressive strengthening and flexion exercises continue as the tendon heals. The splint is removed in this phase. Range of motion improves steadily with consistent adherence to the programme.
Weeks 8–12
Return to light and moderately heavy work is typically achievable at eight to twelve weeks. Return to contact sport and high-load activity follows once grip strength and range of motion are confirmed adequate by your physiotherapist.
EXPECTED OUTCOMES
With early surgery and disciplined rehabilitation, the majority of patients regain strong, functional use of the repaired finger.
WHY EARLY SURGERY MATTERS
Jersey finger deteriorates quickly. The retracted tendon scars and shortens with every passing day. Professor Hindocha prioritises rapid assessment and surgical booking to protect the window for a primary repair.
The avulsed tendon is retrieved and reattached to the bone at the fingertip using sutures or anchor fixation, restoring the anatomical position required for normal finger flexion.
Jersey finger is classified into three grades based on how far the tendon has retracted. The surgical approach is tailored to the grade of injury — ensuring the most appropriate technique is used for the specific injury pattern.
Surgery alone does not guarantee a good result. A controlled, progressive physiotherapy programme — coordinated from the day of surgery — is essential to achieve the best final range of motion and grip strength.
THE WINDOW IS SHORT
The flexor tendon is under natural tension. Once avulsed, it retracts and — without surgical intervention — begins to scar in its shortened position. This process is irreversible. The outcomes of late or untreated jersey finger are consistently poor and often permanent.
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I caught my finger in a tackle and couldn’t bend the tip at all. I was operated on within days. After twelve weeks of physio I had full movement back — I was back playing within the season.
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Professor Hindocha explained exactly what had happened and what the surgery would do. I followed the physio protocol strictly and the result was excellent. Highly recommend acting quickly if this happens.
“
I was back at work — heavy manual labour — at eleven weeks. The splint and physio were non-negotiable but they made the difference. The finger works completely normally now.
DO YOU HAVE JERSEY FINGER?
Jersey finger should be suspected and assessed urgently after any forceful finger hyperextension injury. Common signs and circumstances include:
FOLLOW THE PROTOCOL EXACTLY
A reattached FDP tendon is mechanically vulnerable in the weeks after surgery. The repair is strong enough to tolerate carefully controlled movement under physiotherapy supervision — but not casual unsupported use. The splint and the physio protocol work together: one protects the repair, the other prevents the adhesions that cause permanent stiffness.
Athletes in particular are tempted to rush this phase. Do not. Re-rupture of a repaired FDP tendon typically requires a second, more complex reconstruction with significantly worse outcomes than the original repair. Strict protocol adherence is the single biggest controllable factor in your result.
RELATED HAND INJURIES
Specialist hand trauma and tendon surgery at the same clinic.
HAND SURGERY
Extensor tendon rupture at the fingertip causing it to droop — the counterpart to jersey finger on the back of the hand.
HAND SURGERY
Broader tendon lacerations and ruptures from cuts, trauma or rheumatoid disease affecting grip and finger movement.
HAND SURGERY
Surgical fixation of displaced or unstable fractures of the metacarpals and phalanges.
ACT QUICKLY — TIMING IS EVERYTHING
Early repair. Better outcomes. Every time.
If you or someone you know has sustained a suspected jersey finger — particularly during sport — do not wait for the swelling to go down before seeking assessment. The window for primary tendon repair narrows quickly. Professor Hindocha will assess the grade of injury and arrange surgery as promptly as possible.
FREQUENTLY ASKED QUESTIONS
What patients and athletes ask us most often about this injury.
