Trigger finger snap
Introduction
Introduction The trigger of the trigger finger is one of the main symptoms of tenosynovitis of the finger flexor. The trigger finger is also called the snap finger, which is medically called "finger flexor tendon sheath inflammation". It refers to the movement of the finger in the alternating action of bending and straightening, and the tendon is restrained at the joint of the palm and the finger, resulting in a sickness of the sound. Finger flexor tenosynovitis is one of the most common hand-surgical diseases. It is mainly characterized by the patient's feeling of soreness and pain in the palmar joint of the metacarpophalangeal joint during the flexion and extension of the finger movement. In severe cases, there will be a ringing or even a lock. , leading to dysfunction of flexion and extension. Although the disease can be ill in both adults and children, its etiology and treatment are different.
Cause
Cause
Pediatric finger flexor tenosynovitis, also known as congenital stenotic tenosynovitis, is caused by abnormal thickening of the A1 tendon sheath leading to sheath stenosis. The flexor tendon forms a hard knot in the proximal end of the A1 tendon sheath, resulting in flexion and extension of the finger. . However, whether the cause of the disease is innate or acquired is still controversial.
The cause of adult finger flexor tenosynovitis is more related to the strain of the finger. Due to repeated flexion and extension of the finger in a short period of time, the aseptic inflammatory changes of the tendon sheath tissue are caused, and eventually the tendon sheath is thickened and the sheath is narrowed. On the other hand, due to strain or changes in hormone levels in women (pregnancy or menstrual period), the flexor tendon of the finger is swollen, and the volume of the tendon sheath is limited, so that it can form a stenotic compression with respect to the swollen tendon.
In addition to the above causes, there are some aggravating factors such as cold irritation, diabetic patients, periorbital synovitis, and rheumatoid patients.
Examine
an examination
Related inspection
White blood cell differential count flexion test
General symptoms
Slow onset, common in housework and manual operators, more common in middle-aged and older women. Any finger can be ill, but the middle finger and ring finger are the most common, mainly characterized by localized pain in the volar side of the metacarpophalangeal joint and restricted finger movement. As the tendon sheath is aggravated and the tendon is compressed, it is a gourd-like enlargement. Some will be difficult or impossible to slide through the narrow tendon sheath, and the fingers will stay in the straight position or the flexion position will appear interlocking.
2. Local signs
During the examination, a nodule can be touched at the local tenderness of the patient's metacarpal head. When the finger flexes and stretches, the nodule can be felt to slide, but it is often blocked by the narrowing of the tendon sheath. When the force continues, it can suddenly slide through the similar trigger. Accompanied by the sound of bounce or bounce, the disease is also called the trigger finger, finger, finger and so on.
According to the medical history, clinical symptoms, signs, and the sound of the trigger finger, it can be diagnosed.
Diagnosis
Differential diagnosis
Joint pain: When the knees are lifted, there is a sound in the knee joint, and there is a sound in the cervical spine. When the fingers touch the fingers, there are sounds. These sounds are often called snapshots. Joint sound is a normal phenomenon, because The sound produced by the sliding of the tendon during the activity is not the sound of the bone, nor the lesion of the knee joint, but if the sound is accompanied by pain, then it should be vigilant.
