Inability to flex the interphalangeal joints

Introduction Tendon tendon injury is one of the most common hand injuries, and the symptoms are that the interphalangeal joints cannot flex. The different parts of the extensor tendon are broken, and the corresponding joints cannot be stretched and deformed.

Cause

The wounding factors of this disease are more common in sharp cutting injuries, electric saw injuries, sudden injury caused by sudden injury, crush injuries and so on. Closed lacerations can also occur with neurovascular injuries or bone and joint injuries. Mostly open, with more cut injuries, often associated with neurovascular injury or bone and joint damage, can also occur closed laceration. After the tendon breaks, the corresponding joint loses its function.

an examination

Related inspection

Electromyography synovial fluid routine examination

The clinical manifestations of this disease are mainly after the tendon rupture, the corresponding joint loses its active function.

1, refers to the shallow flexor tendon rupture corresponding to the proximal interphalangeal joint can not flex.

2, refers to deep flexor tendon rupture, manifested as the distal interphalangeal joint can not flex.

3, refers to the deep and shallow flexor tendon rupture, the distal and proximal interphalangeal joints can not flex. Since the intramuscular muscle is still intact, the flexion of the metacarpophalangeal joint is not affected.

4. The different parts of the extensor tendon are broken, and the corresponding joints cannot be stretched, and deformities may occur.

Differential diagnosis

The index finger and middle finger are stiff and painful: it is one of the symptoms of cervical hyperplasia. The patient's symptoms are mainly caused by a sudden or severe pain, severe pain or numbness in the neck occipital or neck and shoulders, and along the direction of the affected nerve roots, to the place where the nerve root is distributed; On the side of the ground, the upper limbs, the back of the hand, the fingers, etc. can also have radioactive pain and numbness. The pain is burnt or knife cut, accompanied by acupuncture or over-the-counter string; when the neck is active or coughing, hitting When sneezing or exerting force, the pain and stringy feeling can be aggravated. The patient does not dare to laugh when joking. The site of radiation pain is related to the segment of cervical lesion. In addition, there may be appearances such as upper limbs sinking, soreness, weak grip, falling objects, and even the pen can not hold, and it is difficult to hold other things. In the evening, the neck, shoulders and upper limbs may be more painful, unable to fall asleep, and it is prone to numbness and numbness after suffering from limb compression.

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. Physical examination is the main one. Perform a myoelectric examination if necessary. Symptoms: the ulnar wrist flexor and the deep flexor ulnar side axillary, atrophy. Can not bend the wrist to the ulnar side and the distal knuckles of the little ring of the ring. When the finger is flat, the little finger can't climb the desktop. The muscles in the hands are extensive. Small fish, interosseous muscle and the 3rd and 4th sacral muscles, the adductor pollicis muscle and the medial head of the buckling short muscle. There is a significant depression between the small fish and the metacarpal. Ring fingers and little fingers have claw-shaped deformities. The claw-shaped malformation on the elbow is lighter, such as the distal injury of the deep flexor nerve. Because the deep flexor loses the antagonistic effect of the internal muscle, the claw-shaped deformity is obvious, that is, the metacarpophalangeal joint of the ringlet is overextended. The interphalangeal joint is flexed, and the interphalangeal joint cannot be extended while flexing the metacarpophalangeal joint. Due to the antagonistic action of the temporal sacral muscle, the middle finger of the food has no claw deformity or only slight deformity.

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