Rashad Johnson’s Fingertip Injury – How Are Fingertip Injuries Treated?

Arizona Cardinals safety Rashad Johnson injured his fingertip in a game against the New Orleans Saints last week. How did this happen? What was the surgery like? What happens now? I’ll answer these questions and more in this article.

Our fingers are always vulnerable – we stick them in places we shouldn’t, and there’s ten of them to injure at any given time (or on any given Sunday!). In the NFL, fingers are even more prone to injury. Dislocations, jamming injuries, and fractures of the hand are common in football.

How did Rashad injure his hand?

Apparently Rashad shook off a block and tried to make a tackle during a game against the New Orleans Saints. I haven’t seen a video of the injury, and haven’t read any details of who he hit or where his hand might have been.

Here’s the picture of his injured finger that he sent out on Twitter at the time.

 

The picture shows the following:

• exposed bone at the distal phalanx level
• blood
• part of the nail ripped off and fractured
• missing skin from underneath the nail

This means his finger was violently smashed.

This could happen by a severe jamming injury, but most commonly happens when the player gets his finger caught between two colliding helmets.

Another possibility is that he could have caught the fingertip in a player’s face mask or pads and it could have been a “ripping” type injury, even though his glove wasn’t torn.

My vote is for a helmet-related crush injury.

In non-athletes, these usually happen in industrial crushing accidents or with a machine like a wood splitter.

How are fingertip injuries treated?

There are three main ways these injuries are treated by hand surgeons:

• let it heal on its own with bandage changes
• try to repair everything
• shorten the fingertip with a partial amputation

Healing on its own

This is actually a very good option in non-athletes. It makes the finger as long as possible with minimal risk. The problem is that it takes the longest of all the options: up to 6 or 8 weeks, and the dressings have to be changed either daily or once every few days.

Not usually something an NFL safety will choose…

Fixing the fingertip

These injuries involve massive trauma to the finger: broken bone, ripped off skin, torn nail tissue, etc.

Sometimes, as in Rashad’s case, the missing skin is lying on the ground or in a glove. Usually it’s pointless to try to sew this back on – the tissue is too severely damaged to live or stay healthy (it’s often just a source of infection).

Skin grafts are an option, along with pinning the finger with stainless steel wires, or even bone grafting. Former cornerback/safety Ronnie Lott opted for amputation when doctors told him a bone graft may take six months to heal.

So, depending on the level of damage done to the finger, surgical repair can be done, and this is often the case in most patients who have some skin and tissue left to repair.

Partial amputation

Based on some media reports and Rashad’s own description of his left middle finger after the surgery, I think he chose this option.

Partial amputation involves removing enough bone and tissue from the fingertip so the skin can be repaired and no additional surgery or bone healing is required.

So the finger is shorter than it was before, and may be slightly weaker with gripping than before. This is true if the end bone is totally removed, leaving the patient with two joints instead of three.

Once the skin has healed, the athlete can return to sports with proper protection for the finger. This usually happens in 2 weeks.

If the player returns too early, the fingertip incision could bust open and cause further bleeding and risk of infection.

Infection and future surgery or complications are still possible, but are much less likely than if the surgeon tried to repair every damaged part of the fingertip.

Questions about this injury or want more details? Ask in the comments below!

Other NFL players with fingertip injuries

Like most injuries that get a lot of attention, this isn’t the first time (nor the last) this has happened.

In this clip from ESPN, former safety Louis Riddick describes a similar crushing injury – a fingertip crushed between two helmets.

In this series of short articles, you can read about former safety Ronnie Lott, who chose amputation rather than wait the possible 6 months it might take for a bone graft to heal in his pinky finger.

Tough athletes who played through injuries

Wikipedia article on Ronnie Lott

Questions about Rashad’s injury or want more details? Ask in the comments below!