Russ gets surgery on the finger, the middle

You probably know the basic outline by now: Russell Wilson suffered an injury to his middle finger in Thursday night’s game. He had that injury operated on Friday, and recovery time is pegged at about six weeks.

But if you want to know why it’s “mallet finger” and the difference between a soft-tissue injury and a bony fragment, keep reading! I sought info from two different hand surgeons because that’s the kind of thing I do for this newsletter.

Before we talk about what “mallet finger” is, let me address the elephant in the room. At least it was the elephant in the room for me: Why’s it called mallet finger? More specifically: Is it because the injury is often suffered while using a mallet or because the finger is left resembling a mallet? I could see it being the former given the frequency with which I have hit my own fingers and thumbs with a hammer, with a mallet and even on two occasions with a sledge-hammer (would not recommend). Turns out it is the latter.

When the finger is fully extended, the fingertip is left at a 90-degree angle to the rest of the digit. This is because the extensor tendon, which is what allows you to “pull” your finger to full extension has ruptured.

The first orthopedic surgeon I talked to, Dr. Gleb Medvedev in New Orleans, pointed out that “mallet finger” is usually divided into two types of injuries. I talked to him because I read his explanation of the thumb injury Drew Brees suffered two years ago. What Brees suffered is called “gamekeeper’s thumb” not be confused with “mallet finger.”

There are two different types of injury that result in mallet finger. The first, is a flat-out rupture of the tendon. A soft-tissue injury. This will heal, but usually takes about eight weeks to heal, and the general approach is to immobilize the finger, fully extended, using a plastic splint.

The second scenario is what is called a bony fragment where the tendon actually pulls away a chunk of the bone from where it attaches to the distal phalanx, which is the last bone in your finger. The tendon attaches to the distal phalanx just in front of where the fingernail bed begins.

Now, here’s the thing to know about the bony fragment is that it’s actually a little quicker prognosis, not because it heals faster than a soft-tissue injury, but the bone becomes solid enough to return quicker than a tendon reaches that strength. There’s still the potential for re-injury as it will be months before the body heals to the point it is as strong as it was preinjury.

OK, so that’s the basic sketch, what does this mean for Wilson? Let’s go to NFL Network insider Ian Rapoport:

This would indicate that Wilson had a ruptured tendon as opposed to a bony fragment.

But then came this report later that day:

Generally, screws are used if there’s a large bony fragment in which case there would have been a fracture of some sort. If there truly was no bony fragment, it was likely an anchor was used to reattach the tendon to the bone not a screw.

The prognosis: Sounds like a six-week timetable for return. For the record, Brees missed five games coming back from the thumb injury two years ago, but we’ve already discussed that was “gamekeeper’s thumb” which should not be confused with “mallet finger.”

Now, if you’ll pardon me, I’m going to go change out of my scrubs.