The stenosing tendovaginitis

Description:

The stenosing tendovaginitis of fingers is an inflammation of the copular device hands. There is a latent injury between phalanxes of fingers and ligaments of joints which connect brush fingers to a shank. Most often the stenosing tendovaginitis occurs at persons at the age of 40 – 60 years. But there are cases of a latent injury and at children.

This disease can be carried to certain professions – musicians, weavers, milkmaids, plasterers, painters, typists, cashiers and others. That is, those professions where it is necessary to make the same constant movements by a hand, there is constant load of a brush, an overstrain and microtraumatization. And this constant microtraumatization leads to a stenosis of tendinous channels, i.e. to their narrowing.

The reasons of the stenosing tendovaginitis:

It is possible to carry certain professions at which big constant load and tension of fingers, and also the wrong provision of a brush are necessary to the reasons of the stenosing tendovaginitis.

Symptoms of the stenosing tendovaginitis:

At a stenoziruyeshchy tendovaginitis of a back ligament of wrist on the course of the first channel the following symptoms are noted:
- pain in a beam bone. Pain can be only at the movement a thumb, and can have constant character. Sometimes pain extends to an elbow or shoulder joint. There can be a restriction of the movement in a thumb, especially at extension;
- swelling;
- rapprochement of tips of the 1st and 4th (or the 5th) fingers it is very painful or it is impracticable.


Symptoms at the stenosing tendovaginitis of a cross ligament of wrist following:
- pain of the aching character in fingers of hands (especially the 2nd and 3rd fingers), amplifies at extension of fingers;
- numbness of fingers;
- skin of fingers pale, can have a cyanotic shade.


Of the stenosing tendovaginitis of ring ligaments of fingers it is characteristic:
- the finger pain strengthening at bending extension;
- clicking of a finger;
- pain when pressing on a palm;
- small swelling.
Allocate the following forms of the stenosing tendovaginitis:
1. The stenosing tendovaginitis of a back ligament of wrist on the course of the first channel. This form of a disease appears as a result of constant traumatization of a back sheaf. It leads to squeezing of sinews of a short razgibatel of a thumb of a brush and long abductor. On X-ray the thickening of soft tissues in the field of an awl-shaped shoot of a beam bone is visible.

2. The stenosing tendovaginitis of a back ligament of wrist on the course of the sixth channel. Appears because of squeezing of a sinew of an elbow razgibatel of a wrist and a back branch of an elbow nerve.

3. The stenosing tendovaginitis of a cross ligament of wrist. It meets diseases more often at people whose work is connected with constant wrong position of a wrist (for example, permanent job at the computer). There is a wrinkling of a cross ligament of wrist therefore there is a squeezing of sinews, nerves and vessels.

4. The stenosing tendovaginitis of ring ligaments of fingers. This disease is characteristic of those professions where at load of hands the big pressure upon a palm is necessary (welders, polishers, cutters, etc.). There is a thickening of a ring-shaped sheaf, it leads to a short-term delay of a sinew at extension, and there is "click". Because of the main symptom this form of the stenosing tendovaginitis still call "the clicking finger".

Development of inflammatory process which leads to a stenosis (narrowing) of sinews on a hand is characteristic of all forms. In parallel there is a squeezing of nerves, blood supply disturbance. All this leads to disturbance of work of functions of hands.

Treatment of the stenosing tendovaginitis:

At an initial staliya carry out a brush immobilization for the term of not less than 2 weeks with co-administration of physiotherapeutic procedures. Widely apply paraffin applications, dirt, ozokerite. Massage is categorically contraindicated.

Further hydrocortisone injections under a back sheaf on the course of the channel are recommended.

It is better to appoint a hydrocortisone (25 — 30 mg) with 0,5% solution of novocaine (no more than 3 — 5 ml).

At far come cases an operative measure — a section of a back ligament of wrist on the course of l-go of the channel is shown. After operation, as a rule, function of a brush is recovered.