Complete loss of extension function of fingers, thumb and epigastric

Introduction The complete loss of the extension function of the fingers and the ankles is one of the clinical symptoms of the extensor tendon injury of the hand. The stretching system of the finger is a combination of tendon and fascia, aponeurosis and ligament. Its function and structure are far more complicated than the flexor tendon system. It is called anatomical dorsal aponeurosis, also known as extensor apparatus. ). This disease is caused by cutting injuries and reaming injuries. After the tendon trauma is broken, due to the contraction of the muscle, the proximal end of the retraction can even retract very far, such as at the proximal knuckle, the cut end can be retracted back to the palm, no bleeding vessels can be seen in the tendon Cut off. Whether it can heal itself like other tissues has been controversial. The exogenous healing theory has dominated for a long period of time. It believes that tendons lack the ability to heal themselves and must be granulated by the surrounding blood-rich tissues to repair them.

Cause

(1) Causes of the disease

More due to cutting injuries and hinge injuries.

(two) pathogenesis

After the tendon trauma is broken, due to the contraction of the muscle, the proximal end of the retraction can even retract very far, such as at the proximal knuckle, the cut end can be retracted back to the palm, no bleeding vessels can be seen in the tendon Cut off. Whether it can heal itself like other tissues has been controversial. The exogenous healing theory has dominated for a long period of time. It believes that tendons lack the ability to heal themselves and must be granulated by the surrounding blood-rich tissues to repair them.

an examination

Related inspection

Limb and metacarpal muscle strength test of limbs and joint movement

After each injury, the extension function of each finger, thumb and ankle is completely lost.

The extensor tendon can also be divided into 5 zones.

Zone I: From the end to the central point.

Zone II: Central stagnation to the middle of the proximal phalanx (distal extension of the iliac crest).

Zone III: the extension of the ankle to the distal edge of the dorsal ligament of the wrist.

Zone IV: the area of the ligament of the wrist.

Zone V: Forearm.

According to the history of trauma, the injured part, the dysfunction of the thumb and fingers, the diagnosis is generally not difficult.

Differential diagnosis

Can not stretch the thumb: flexor tendon sheath inflammation 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.

Can not flex to the ulnar side of the wrist and the distal ring of the flexor ring of the little finger: common in the ulnar nerve injury, other symptoms include the injury on the elbow, the ulnar wrist flexor and the deep flexor ulnar side.

The interphalangeal joint cannot be flexed: the symptom of the extensor tendon injury is that the interphalangeal joint cannot flex.

Fingers can not flex and stretch: 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.

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