Can't flex the fingers

Introduction Finger flexor tenosynovitis can cause fingers to bend and stretch. Mainly manifested as limited pain in the volar side of the metacarpophalangeal joint and restricted finger movement. As the stenosis of the tendon sheath is aggravated and the tendon is swollen after the tendon is compressed, most of the swelling will be difficult or impossible to slide through the narrow tendon sheath, and the finger stays in the extension or flexion position, and the interlocking phenomenon occurs.

Cause

(1) Causes of the disease

The tendon sheath is caused by chronic aseptic inflammation caused by mechanical friction of the flexor tendon contraction.

(two) pathogenesis

The site of finger flexor tenosynovitis is at the beginning of the flexor tendon fiber sheath corresponding to the metacarpal head (ie, the A1 block), where the thicker annular fiber tendon sheath and the metacarpal head form a relatively narrow sheath inlet. Although the tendon sheath of the thumb is connected to the wrist bursa, there are two sesamoids at the head of the metacarpal, and the passage is narrow. When the item is grasped, the tendon slides and tightens. At the trochlear joint of the metacarpophalangeal joint, the tendon is bent and rubbed most, and the tendon sheath is pressed forward and backward by the article and the metacarpal head, which is prone to damage and gradually proliferate and narrow.

an examination

Related inspection

Small finger flexion test thumb small fingertip relative test elbow test bone and joint soft tissue CT examination

1. General symptoms: Slow onset, common in housework and manual operators, more common in middle-aged and older women. Any finger can develop disease, but the thumb, middle finger and ring finger are the most common. Mainly manifested as limited pain in the volar side of the metacarpophalangeal joint and restricted finger movement. As the stenosis of the tendon sheath is aggravated and the tendon is swollen after the tendon is compressed, most of the swelling will be difficult or impossible to slide through the narrow tendon sheath, and the finger stays in the extension or flexion position, and the interlocking phenomenon occurs.

2. Local signs: During the examination, a nodular joint 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 slip through. Similar to triggering the trigger, accompanied by snapping or bouncing, the pain is obvious, so the disease is also called the trigger finger, snap finger, plucking finger and so on.

According to the medical history, the clinical symptoms and signs can be diagnosed by the trigger of the trigger finger.

Differential diagnosis

Flexion refers to the change of flexion deformity of the finger. The flexion of the finger often has a family history. It begins to be inconspicuous and gradually increases in flexion, often accompanied by other systemic syndromes such as Doun syndrome.

Finger numbness: The sensory nerve of the finger is distributed by the nerve roots separated by the cervical spinal cord to the hands and fingers. When the nerve damage occurs in some parts, inflammation, tumor, pressure, etc. cause abnormalities, fingers appear. Numbness.

After a sprained finger, the joint is locally swollen, the joint is limited, and the stretch is not straight or bent. This is a symptom caused by ligament injury.

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