The term stenotic ligamentitis takento call a pathological change in the state of the tendon and its surrounding ligaments, which leads to a constantly bent position of the finger (less often, several fingers) of the hand. Due to the fact that at the beginning of the disease when the extension of the phalanx is heard a click, it has another name - “snapping finger”.
History of the study of stenosing ligamentitis
For the first time about this disease in 1850Dr. Nott mentioned in his works (by the way, the disease was later named after him). He spoke about the phenomenon in which patients complain about problems that arise when trying to bend or bend a finger. And in 1887, Dr. Schönbern made the first operation, during which he cut the pathological burden.
Since then, in specialized editions appearedmany messages, the subject of which was stenosing ligamentitis, treatment and methods of diagnosing this disease. And since 1966, the Russian doctor N. P. Shastin proposed a method of surgery for use, which he called minimally invasive ligamentotomy.
What is this disease?
Стенозирующий лигаментит относят к polyetiological (ie, occurring for many reasons) disorders of the tendon-ligament apparatus in the hand. It is characterized by the infringement of tendons in the lumen of the fibrous canals, caused by the inflammatory process of the contractile nature in the heaviness that connects the muscles with the bone.
On the brush of each person there are so-calledring-shaped ligaments, which hold the bent finger in this position, preventing it from straightening. Here, most often occurs with Nott's disease and contracting inflammation. In this case, the ligaments are narrowed, and the tendon thickens, which causes over time the main symptom of the disease - constantly bent finger.
Who is most susceptible to stenotic ligamentitis?
To date, the causes ofstenotic ligamentitis of the fingers is not well understood. It is believed that the basis of this disease are microtraumas and overstrain of the hands, caused by the same forced position for a long time.
This happens mostly in people working formachine, or those who are forced during the work to make frequent grasping movements. Therefore, the disease is classified as professional. And most often they suffer musicians, cashiers, welders, cutters and bricklayers.
Often, various chronic inflammations of the ligaments and joints lead to this pathology: polyarthritis, rheumatism, etc., as well as the presence of diabetes mellitus.
Some authors claim that ligamentitis is also a hereditary disease. But studies that could confirm or deny this claim were not conducted.
The course of the disease in children
Stenosing ligamentitis occurs in childrenquite rare. And the main reason for its occurrence, doctors call the rapid growth of individual structures and tissues in the brush. That is, the diameter of the tendon in this case increases faster than the lumen of the annular ligament, which leads to a kind of conflict between them, causing chronic inflammation. It eventually leads to degenerative changes in the tendon-ligament apparatus.
Most often it affects children from one to three years old and in most cases on the thumb. Unfortunately, there is still no sufficient explanation for this phenomenon.
Parents may notice that a child is having difficultystraightens the finger, and at its base there is a small, with a pea, thickening. This should serve as a reason for compulsory treatment to a specialist, otherwise the disease will lead to a persistent forced finger position.
The main symptoms of stenosing ligamentitis
Stenosing ligaments have severe symptoms: for example, while pressing on the base of a disturbing finger, the pain becomes more acute.
- At a finger functionality decreases.
- The pain, by the way, does not focus only in it, it can give to the hand and even to the forearm.
- At the base of the finger, you can grope a painful tight bump, and he or one of his joints may swell.
- The finger often goes numb.
- After prolonged immobility of the hand, the symptoms become especially bright.
And of course, the main feature is a click that occurs every time you try to bend or unbend an affected finger.
Stages of development of the disease
Stenosing ligamentitis of the thumb, as well as other fingers, develops in stages. In the first stage, clicking and soreness do not appear too often.
But as soon as you need to straighten your fingermake serious efforts, we can talk about the onset of the second stage of the disease. The tendon at this stage usually thickens, and a lump appears under the disturbing finger.
The last, third stage is characterized by the inability to straighten the sore finger. But to wait for this, of course, is not worth it, it is better to consult a doctor in time and get rid of the illness.
Diagnosing
If stenotic ligamentitis is suspectedappeal to the oteopedo-traumatologist. The doctor examines the affected hand. In addition, the patient must make her radiograph, which allows to distinguish the disease from arthrosis or arthritis. Additional tests are usually not required.
Due to the fact that the described pathology, as a rule, develops very quickly, with the first sensations of discomfort or pain when moving with your finger, you should turn to an orthopedist.
Methods of treatment of stenotic ligamentitis
Предпринимаемое при диагнозе «стенозирующий ligamentitis treatment depends on the stage of the disease and the patient’s general condition. In the early stages, it is recommended to use physiotherapeutic procedures, in the form of electro- and phonophoresis with drugs that improve microcirculation, as well as applications using paraffin and medicinal compresses.
In a later period and in the event thatphysiotherapy does not give the expected results, prescribe additional medications - it can be anti-inflammatory and painkillers. Hydrocortisone injections in the area where there is a thickening are very popular.
The patient is required to immobilize the finger. An important condition is the change of work, as well as careful avoidance of traumatic factors.
Stenosing ligamentitis: surgery
If the measures taken do not give the desired result or in the case when the patient asked for help in the third stage of the disease, he was shown surgery.
During it, the patient is dissectedligament, which prevents the movement of the tendon. According to N. P. Shastin's method, this operation is done through a puncture puncture with the help of special disposable tools. This does not require the conditions of the hospital and enough local anesthesia.
When conducting an open ligamettotomy patientunder general anesthesia, an incision is made that does not exceed 3 cm. And then the incision is cut through. After this operation, the brush is fixed with a plaster cast.
Each of these operations has its drawbacks and positive qualities, so only a doctor can decide exactly how surgery will be performed.
Folk treatment
Stenosing ligamentitis in addition to prescribed procedures can be consulted withdoctor, treat and folk remedies. The most popular of these is the so-called dry heat. To do this, warm up the sea or table salt in a pan, which is then poured into a tight bag of canvas. Brush turn palm up, and put the bag on it. Such heating can be done twice a day, not allowing hypothermia between treatments.
Mud compresses are also good, for whichAny therapeutic clay is diluted to a thick cream and 5 dessert spoons of apple cider vinegar are added to it. This gruel is spread on a sore finger with a thick layer, and is placed on top with cellophane. Remove the compress after 2 hours. After that, the hand needs complete peace and warmth.
But remember that when diagnosing stenosing ligaments treatment with folk remedies can not give any significant results.
