The CLICKING FINGER (a synonym: the latched finger, the springing finger, the nodal tendinitis stenosing a tendovaginitis of a ring-shaped ligament of finger) — the alternating contracture of fingers of a brush.
It is observed, as a rule, at persons of certain professions (cutters, tailors, typists, hairdressers, shoemakers), is more often at women.
The etiology is insufficient is found out. The disease results from an aseptic inflammation of a ring-shaped ligament of tendinous vagina (a ring part of a fibrous vagina, T.) at the level of the basis of a proximal phalanx of fingers of a brush, a cut leads to their consolidation and narrowing of a ring of a sheaf. The movements of sinews in a ring-shaped sheaf are at a loss, there is a symptom of «zashchelkivaniye» when the finger is fixed in the provision of bending, and the patient feels an obstacle at its extension.
The disease develops gradually or arises sharply after an unusual exercise stress. Also the IV fingers of a brush are surprised preferential 1, III. Signs Shch. items are a swelling and morbidity in a reinforced ligament, difficulty of bending and extension of a finger. Distinguish three stages of a disease: in an initial stage difficulty of movements of a finger, hl is observed. obr. in the mornings; in the second patients are disturbed more often by «zashchelkivaniye» of a finger, elimination to-rogo is followed by sharp pain; in the third stage there can be a flexion contracture of a finger.
Treatment in an initial stage, as a rule, conservative: thermal procedures, electrophoresis of iodine, whether-dazy, fonoforez hydrocortisone. To the area of a ring-shaped sheaf it is necessary to refrain from injections of a hydrocortisone since at the same time in sinews quite often there occur dystrophic changes. However conservative treatment is not always effective.
At the second and third stages of a disease of the main method of treatment is operational vmeshatelst-
Fig. The diagrammatic representation of the main stage of operation at the clicking finger:
the probe (1) is entered under a ring-shaped sheaf (2) over a reinforced sinew (3) sgibatel of the IV finger; the dashed line designated the line of crossing of a sheaf.
in — a section of the condensed ring-shaped sheaf. Under local anesthesia from longitudinal direct or slightly curved section 15 — 20 mm long in the field of the basis of a proximal phalanx bare a reinforced ring-shaped sheaf. On a sinew distalny sheaves find the thickening hardly passing through the narrowed ring of a sheaf. Under a sheaf bring a fluted probe and cut its (fig.). Edges of a ligament widely disperse, the sinew freely moves during the bending of a finger, and the symptom of a zashchelkivaniye disappears. The wound is sewn up and apply a soft bandage. In 10 days seams are removed, appoint thermal procedures (ozokerite, paraffin), massage, to lay down. gymnastics.
Prevention comes down generally to the prevention hron. traumatizations of area of tendinous vaginas of a brush.
Bibliography: At with about l c e in and E. V. and
M and sh to and r and K. I. Hirurgiya of diseases and damages of a brush, page 147, JI.,
1978; E l to and M. A. and Li's N And.
The stenosing tendovaginites of a wrist and fingers, page 58, L., 1968; L about r t h i-
about i of J. Surgical treatment of trigger-fin-ger by a subcutaneous method, J. Bone Jt Surg., v. 40-A, p. 793, 1958.
L. H. Bryantseva.