Russell Wilson's Mallet finger injury: What should the Seahawks expect?
By Dr. Matt Provencher
FOX Sports Injury & Performance Analyst
The Seattle Seahawks find themselves in a precarious position after losing to the Los Angeles Rams on Thursday night and falling to 2-3, placing them at the bottom of the difficult NFC West.
Even more concerning, though, is the injury to quarterback Russell Wilson, who departed the contest in the third quarter after injuring the middle finger on his throwing hand. Wilson was rushed by Rams superstar Aaron Donald, their hands colliding as he released the ball on a long pass play. He came up holding his right middle finger.
The Seahawks' medical staff evaluated Wilson on the sideline and applied an extensor type of splint to his middle finger. This is a classic splint used to treat this type of injury, known as a Mallet finger. It's caused by damage to the extensor tendon of the finger. This tendon of the finger attaches just below the nail bed and works to extend the finger and keep it straight.
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How does this injury impact a QB?
This type of injury affects a QB's ability to hold and throw the ball. On the sideline, Wilson could be seen gripping a tennis ball to check his grip status.
The ability to grip the ball will be the obvious key for his eventual return in the next several weeks, as the team determines how well he can open his hand, receive the ball from the center, execute handoffs and pass the ball accurately. If Wilson cannot straighten his middle finger, this could impact football transitions — snaps from center to QB, handoffs to the RB, etc. He'll need to be able to open his hand and keep the middle finger — the longest one — out of the way.
In addition, the grip might be an issue as he moves his hand up and down the ball and its stitching, to get where he wants to hold it as a QB.
What is a Mallet finger injury, and how do you treat it?
An X-ray of Wilson's finger came back negative, according to NFL reporter Ian Rapoport.
Next Wilson will have an MRI to assess ligament damage and confirm that there are no fractures.
This will be crucial, as there are two types of Mallet injury. The first is a soft-tissue mallet, in which the tendon is torn off the end of the middle finger just below the nail bed. The second is a bony mallet or fracture of the middle finger joint closest to the fingernail.
Both can be treated with extensor splinting, also known as a "stack splint," full-time for six-to-eight weeks. However, if there is a small fracture or significant bony injured component, or if the joint remains out of place, then surgery is often recommended to stabilize the extensor mechanism, which is important to allow him to get his finger straight. Stabilization can be accomplished with the stack splint, which Wilson would wear full-time. Surgery would involve inserting a stainless steel or titanium pin to stabilize the joint. In certain circumstances, a combination of treatments is necessary.
When can Wilson return?
On Thursday, Seahawks coach Pete Carroll said there was no timetable for Wilson's return.
"There is a lot of work to be done in assessing all of that," he said. "Russell is one of the great healers of all time, and he'll do whatever he can to get back as soon as absolutely possible."
One report has the Seahawks preparing for Wilson to miss at least a month.
But we will wait for additional information. There is a chance that Wilson's medical team will find a creative way to splint the middle finger and have him ready to play, with his game start streak on the line.
We will have to wait for further details from imaging to know the extent of the injury and get a better picture on whether Wilson can hold the ball.
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