Trigger finger

With trigger finger (also snap of his fingers, Spring fingers, lat Tendovaginosis stenosans, tenosynovitis stenosing or Digitus saltans ) is called a system-related disease in which (usually the thumb ) on the bending side metacarpophalangeal joint thickened ( about finger at the junction of palmar ) the flexor tendons of a finger and are thus no longer free by the local ring band (specifically A1-Ring belt ) can slide (so-called ring band stenosis). This results in a ' snap ' of the finger is flexed, the distances must often be helped.

A stenosing tenosynovitis is caused by an overload of the flexor muscles of the hand. Thus, it is in this type of inflammation around no bacterial infection. They often constitutes an occupational disease, as, for example, piano players, athletes, artisans or people who work longer hours at the computer very often suffer from this disease. An incorrect posture and stereotyped movement, there is little injury to the tendons. This occurs more often caused inflammation, resulting due to a concomitant swelling to an even stronger inflammatory response. This results in the tenosynovitis stenosing in the training of tendon nodules ( anular ligament ) must fit and thus produce the phenomenon of trigger finger with each finger movement through the ring band. For this reason, as a conservative treatment a targeted muscle treatment to eliminate muscular imbalances. This can be done for example by trigger point therapy. The patient should receive the same time gentle and relieving exercise program to eliminate the muscular overloads faster. The triggering factors such as playing an instrument, sports and craft activities should be temporarily avoided until the symptoms no longer occur. Since tenosynovitis stenosing is an overload damage, is especially recommended for practicing a musical instrument, a change of practice techniques under the guidance of an experienced therapist to avoid further health problems.

The diagnosis is made clinically, ie on the basis of physical examination. In addition to X-rays to rule out bony changes, if necessary, performed an ultrasound examination (sonography) and in rare cases a layer investigation.

The therapy consists in a minor surgical procedure in which local anesthesia ( local anesthesia ) and after application of a tourniquet, the skin is cut diagonally across the ring band; then the ring band is carefully presented, respecting the parallel to the tendon sheath extending blood vessels and nerves and severed completely through the tendon transversely. Now the free gliding of the tendon is checked and then reinvested the skin closed ( sutured ) and one association. The free move is made after the decay of anesthesia again. The sutures are removed after about a week. Physiotherapy exercise treatment is rarely necessary. Basically, the limb (hand and arm) to be mounted high to prevent excessive swelling for hand surgery.

Alternatively, tentatively a mixture of an anesthetic and a decongestant preparation ( local anesthetic and corticosteroid ) under sterile conditions carefully into the tendon sheath (and not into the tendon ) is introduced ( injected ) are.

In young children, occurs a congenital variant of this disease on the thumb, which is called Pollex flexus congenital (congenital curved thumb). In this, the thumb is at the end link in flexion. Besides the A1-Ring strip another, oblique band extending over the thumb phalanx ( oblique pulley ) still needs to be severed.