This narrative review examines FDP tendon avulsion injuries (jersey finger), covering anatomy, the Leddy-Packer classification system, surgical repair techniques, biomechanical evidence, and management of chronic injuries — asking which repair constructs are best supported by the literature and how to select treatment based on injury pattern.
When you see an acute FDP avulsion, use the Leddy-Packer type to guide urgency and technique: Type I injuries (palm retraction, both vincula disrupted) require prompt repair within 7–10 days before the tendon becomes irretrievable, while Type III injuries (large fragment at A4) may tolerate delayed repair given intact vascularity.
Choose a multi-strand locking repair with braided nonabsorbable suture, and counsel patients upfront that DIP stiffness is the rule, not the exception.
This narrative review examines FDP tendon avulsion injuries (jersey finger), covering anatomy, the Leddy-Packer classification system, surgical repair techniques, biomechanical evidence, and management of chronic injuries — asking which repair constructs are best supported by the literature and how to select treatment based on injury pattern.
When you see an acute FDP avulsion, use the Leddy-Packer type to guide urgency and technique: Type I injuries (palm retraction, both vincula disrupted) require prompt repair within 7–10 days before the tendon becomes irretrievable, while Type III injuries (large fragment at A4) may tolerate delayed repair given intact vascularity.
Choose a multi-strand locking repair with braided nonabsorbable suture, and counsel patients upfront that DIP stiffness is the rule, not the exception.