FINGERS

From Big Medical Encyclopedia

FINGERS (digiti) — distal department of a brush and groans. Fingers of a brush are designated by the Roman figures and have names: I \a thumb (pollex), II — index (index), III — a long finger (digitus medius), IV — anonymous (digitus annularis), V — a little finger (digitus minimus). On P.'s foot are designated by also Roman figures, the I finger is called by big (hallux), and by V — a little finger (digitus minimus). On P. distinguish back, palmar or bottom, medial and lateral surfaces. On a dorsum of the distal ends of P. are nails (see).

P.'s bones, except for bones of thumbs of a brush and foot, are presented by the proximal, average and distal phalanxes connected by interphalangeal joints. Thumbs have two phalanxes — proximal and distal. The bases of proximal phalanxes on brushes (see) are jointed with heads of metacarpal bones, on to foot (see) — with heads of plusnevy bones, forming respectively metacarpophalangeal and metatarsophalangeal joints. The movements in metacarpophalangeal joints are more extensive owing to what P. brushes have bigger mobility.

Skin of a palmar surface of P. of a brush contains a large number of sweat glands; there are no hair and sebaceous glands that excludes possibility on this surface of P. of furuncles. Hypodermic cellulose P. is divided by the connective tissue crossing points going from skin to a periosteum of phalanxes or to tendinous vaginas in this connection purulent process usually extends to P. in depth. Skin of a dorsum of P. is thinner, in average and proximal phalanxes is covered with hair. Palmar fascia of a brush, being attached to a periosteum of phalanxes, creates fibrous channels for synovial vaginas of sinews of sgibately P. V synovial vaginas of sinews the mesentery of a sinew (mesotendineum) is quite often poorly expressed, there are only svyazochka of sinews (vincula tendinum), in the thickness to-rykh blood vessels approach a sinew. Sinews of a superficial sgibatel of P. are attached by two legs on an average phalanx, the sinew of a deep sgibatel of P. passes between them and is attached on the basis of a distal phalanx. Big P. has a vagina for a sinew of a long sgibatel, a cut is attached on a distal phalanx. The short sgibatel of big P. is a part of an eminence of big P. (thenar) and is attached to sesamoids of a metacarpophalangeal joint. Extensor tendons of P. on a dorsum of phalanxes come to an end with three legs: average is attached on the basis of an average phalanx, two side — on the basis of a distal phalanx. Own razgibatel have big, index P. and a little finger.

Kosha is more dense than a bottom surface of P. of foot, than on a dorsum. Sinews of a long sgibatel of P. of foot as well as P. brushes, pass between legs of sinews of a short sgibatel and are attached on the basis of distal phalanxes. Sinews of a short sgibatel are fixed on the basis of an average phalanx. A dorsal aponeurosis, in to-ry extensor tendons of P. pass, forms three legs, to-rye brushes are attached the same as on P.

Due to the distinction of functions of a brush and their P.'s foot have a number of features. So, P. is rather longer than a brush and are more mobile, the thumb can be opposed to other fingers. Items of foot in connection with its basic function are shortened, their averages and distal phalanxes — a knotty form. The thumb of foot is thickened, his muscles are developed more weakly, than muscles of a thumb of a brush; ability of opposition is absent.

Pathology

most often occurs Among malformations of fingers the next P.' union — syndactylia (see), edges it can be combined with other inborn deformations of P. — a polydactylia (increase in number P.) or an oligodactylia (reduction of their number). Sometimes the polydactylia is observed at the same time on a brush and on foot. The hyperphalangy (formation of additional phalanxes) and an aphalangia (lack of phalanxes) are possible. Shortening P. (brachydactyly) — can be caused not only by an aphalangia, but also shortening of phalanxes — a brakhi-falangiya. Rare malformations of P. of a brush are huge P., as a rule, index and average — so-called macro - or mega-lodaktiliya. A peculiar disturbance of development of P. is spider finger (see), shown anomaly of bone system, fingers at the same time remind paws of a spider. Inborn contractures of P. of a brush are rare, generally it is flexion contractures of a little finger. The majority of malformations of P. demands operational treatment, a cut carry out preferential aged 5 years are more senior. In the first years of life preliminary conservative treatment can be required by such children (massage, to lay down. gymnastics, stage redressment, physiotherapeutic treatment, etc.).

The acquired deformations of fingers are usually connected with the postponed severe injury or purulent process of a brush and foot. On foot frequent and typical deformation of a thumb — an excessive deviation of its knaruzha (see. Hallux valgus ). On P. feet, are more often on big, the wrong growth of a nail can be observed (see. grown ), on a brush — a flexion contracture of fingers (see. Dyupyuitrena contracture ).

P.'s injury of a brush which is followed by injury of sinews, bones or traumatic amputation demands, as a rule, recovery operations, including and replantation by means of a microsurgical technique (see. Dislocations , Microsurgery , Tendinous seam ). The item, especially brushes, are subject to a production and household microtrauma with possible development of pyoinflammatory diseases and hl. obr. felon (see), paronychias (see), furuncle (see), erizipeloida (see). Also interphalanx monoarthritis has the traumatic nature — Ching (see). The item, especially stop, are subject to freezing injuries (see). The contact burns arising from contact with the heated objects are characteristic of fingers of a brush (see. Burns ).

Tuberculosis of bones of P. proceeds in shape hron, diaphyseal osteoperiostitis (see), leading to a spindle-shaped thickening of phalanxes — spina ventosa (see); it is observed seldom, preferential at children aged up to 10 years (see. Tuberculosis extra pulmonary, tuberculosis of bones and joints ). P.'s syphilis in the form of a syphilitic dactylitis can arise hl. obr. in primary period of syphilis (chancre felon), sometimes in P., tertiary in the form of a gumma, and it is very rare in the secondary period as a syphilitic tendovaginitis (see. Syphilis ). Heavy, up to mutilation (patol, amputations), P.'s damage of foot is caused by tropical mycosis (see. Madura foot ), and P. of a brush — leprosy (see).

Epithelial cysts of P. of a brush arise from the sites of epidermis which were implemented into the subject fabrics at a microtrauma. The cyst is localized usually on a palmar surface of P. in the form of the education roundish, dense to the touch connected with skin. At increase in a cyst pain is possible; the cyst can suppurate. Treatment operational — removal of a cyst.

From benign tumors enchondromas are most frequent (see. Chondroma ), quite often multiple. They can reach the big sizes, disfiguring a brush, breaking function P. Also hyponychial cartilaginous exostoses — as a rule, a thumb of foot are observed (see. Exostoses ). Treatment operational — a resection, bone plastics.

From malignant tumors of P. epidermoid cancer, the Hyponychial chondrosarcoma, and also a melanoma and an osteosarcoma meet. Treatment of malignant tumors of P. is carried out according to the general principles of the combined treatment of malignant tumors (see. Tumours, treatment ).

See also Brush , Foot .


Bibliography: Operational hkrurgiya and topographical anatomy, under the editorship of V. V. Kovanov, page 268, etc., M., 1978; F Alija L. I. Embriologiya of the person, Atlas, page 103, M., 1976; H a m A. W. Histology, P-595, Philadelphia — Toronto, 1974.


B. I. Kogan (annate.), S. A. Rusanov (hir.).

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