Mallet finger injuries are avulsion fractures of the distal phalanx that commonly result from a finger jam mechanism In adolescents, the injury is often seen on a lateral radiograph ( Fig 109.7 ) A similar tendon avulsion in a younger child might not have an associated fracture Mallet finger injuries are managed in an extension splint In the emergency room setting, AlumaFoam and stack splints may be utilized However, providers should be mindful of appropriate sizing, as splints designed for adults commonly not fit Many of these injuries are treated with immobilization alone Even large fragments may not require surgical care, however all mallet finger injuries should be referred to a hand specialist FIGURE 109.6 Seymour fracture A : Lateral radiograph depicting a displaced distal phalangeal physeal fracture in the setting of a nail bed injury B : Intraoperative photograph after nail plate removal depicting the tear in the germinal matrix of the nail bed and underlying bony injury (Courtesy of Children’s Orthopaedic Surgery Foundation.) Jersey finger injuries refer to traumatic avulsion of the flexor digitorum profundus tendon at the level of the distal phalanx These commonly occur when the finger is held in flexion and then sustains forceful extension, for example, when a football player is attempting to tackle another player with their fingers There is often pain on the volar aspect of the finger, with the affected finger held in slight extension ( Figs 109.2 and 109.8 ); the patient cannot actively flex the DIP joint These injuries commonly occur without an associated fracture but require urgent referral to a hand specialist for operative repair