Inability to extend thumb

Introduction Flexor tenosynovitis occurs mostly in the thumb and middle finger. The flexion and extension dysfunction of the affected finger is particularly obvious when waking up in the morning, and can be alleviated or disappeared after the activity. Pain sometimes radiates to the wrist. The flexion of the metacarpophalangeal joint can be tender, sometimes with a thickened tendon sheath and a pea-sized nodule. When bending the affected finger, suddenly staying in the semi-bend position, the finger can neither straighten nor bend, as if it is suddenly "snapped", the pain is unbearable, and with the other hand assisted to move, the finger can move again, resulting in Like the action of the trigger machine and the sound, it also has the name of trigger finger or snap finger.

Cause

Causes of tenosynovitis: It can be caused by injuries, excessive strain (especially in the hands and fingers), osteoarthritis, some immune diseases, and even infections. Some occupations that require long-term repeated strained joints, such as typists, cargo handling, or industries that require long periods of computer operation, can cause or exacerbate the disease. Common affected areas include wrists, fingers, shoulders and other positions. Women and diabetics are more susceptible to this disease. The patient will feel joint pain, morning stiffness, and usually the feeling of morning stiffness of the joint is most obvious after getting up, and the symptoms will not be relieved obviously with frequent activities. The affected joints are swollen and even bounced, and joint movement is impaired.

an examination

Related inspection

Muscle force test of thumb flexor muscle strength test

The flexion and extension dysfunction of the affected finger is particularly obvious when waking up in the morning, and can be alleviated or disappeared after the activity. Pain sometimes radiates to the wrist. The flexion of the metacarpophalangeal joint can be tender, sometimes with a thickened tendon sheath and a pea-sized nodule. When bending the affected finger, suddenly staying in the semi-bend position, the finger can neither straighten nor bend, as if it is suddenly "snapped", the pain is unbearable, and with the other hand assisted to move, the finger can move again, resulting in Action like a trigger and a snap. Tenosynovitis is the flexor and flexor tendon, and the stenosis is on the volar side of the metacarpal neck. The shortness of the thumb and the long thumb of the thumb are in the sheath here. When the fist is on the wrist when the disease occurs, it causes pain and tenderness. The ganglion cyst is unintentionally found and painless. Some may have weakness or soreness. The mass does not adhere to the skin, its base is connected to the tendon sheath or joint capsule, and some are connected to the joint cavity.

Differential diagnosis

Differential diagnosis of unable to stretch the thumb:

1. Thumb adduction malformation: Clinical manifestations of sacral nerve injury in exercise: When the upper arm sacral nerve is injured, each extensor muscle is extensively sacral, triceps, diaphragm, iliac crest, circumflex muscle, and supinator Refers to the total muscle, ulnar wrist extensor muscles and the index finger, the small intrinsic extensor muscles of the little finger. Therefore, the wrist is drooping, the thumb and each finger are drooping, and the knuckles cannot be extended. The forearm has a pronation deformity, can not be rotated, and the thumb is deformed.

2, thumb sign: Ma Fang syndrome also has congenital mesoderm dysplasia, Marchesani syndrome, spider indications, limb slenderness, characterized by peripheral connective tissue malnutrition, skeletal abnormalities, internal eye disease and cardiovascular Abnormality is a hereditary disease characterized by connective tissue as a basic defect. Thumb sign: The thumb is adducted, and the remaining 4 fingers are fists. The tip of the thumb is beyond the lower edge of the palm, and about half of the patients have this sign.

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