Central Slip Injuries

In a nutshell...

What is it?

There is a complex arrangement of muscles and tendons that between them enable you to lift your fingers straight. One small band of tendon crosses over the top of the middle finger joint, and is called the Central Slip. Any injury to the middle joint (especially dislocations) may result in a central slip injury, but fortunately it is not a common injury.

How can I tell if it is injured?

In the early stages after a middle joint injury it can be very difficult to identify a central slip injury. If your doctor or physio are suspicious they will probably recommend an ultrasound. After a while, the injured finger will start to drop into a bent position (see diagram) which is called a Boutonniere Deformity.

How long will it take to heal?

If not treated, the tendon will never heal. With good treatment (splinting and appropriate exercises) a good recovery is usually possible in 10-12 weeks.

What kind of splint should I use?

The finger will need to be splinted in a completely straight position, full time, for the first 3-4 weeks. We fit the finger with a custom-made thermoplastic splint, but it may be possible to use ZimFoam or even a pop-stick.

When do I start exercises?

The timing varies, depending on your injury and how it is healing. When it is safe (usually at least 3 weeks), your physiotherapist will advise you about changing to part-time splint use. A very gentle exercise program can be started at this stage, often using a second ‘exercise template’ splint to ensure you don’t bend the finger too far too soon.