Long extensor thumb. Treatment of damage to the long extensor of the thumb
The extensor hallucis longus is highlighted in blue. |
|
| Latin name |
Musculus extensor pollicis longus |
|---|---|
| Start | |
| attachment |
distal phalanx of the first finger |
| blood supply |
a. interossea posterior, a. radialis |
| innervation |
n. radialis (C VI-C VIII) |
| Function |
extends the thumb |
| Catalogs | |
Long extensor thumb(lat. Musculus extensor pollicis longus ) - muscle of the forearm of the posterior group.
It has a spindle-shaped abdomen and a long tendon. Lies next to the short extensor of the thumb. It starts from the interosseous membrane of the forearm, the interosseous edge and the posterior surface of the ulna. It goes down and passes into the tendon, which is surrounded by the tendon sheath of the long extensor of the thumb (lat. vagina tendinis musculi extensoris pollicis longi ). Then, having rounded the I metacarpal bone and reaching its back surface, the tendon reaches the base of the distal phalanx, to which it is attached.
Function
Unbends the thumb, pulling it to the back.
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longus.Beginning of the muscle: from the middle third of the posterior surface of the ulna.
Muscle Attachment: to the base of the second phalanx. Function: relieves pain-
my finger.
19. Extensor of the index finger, m. extensor indicator.The beginning of the mouse
tsy: from the distal third of the ulna. Muscle Attachment: to the tendon
common extensor. Function: extends the index finger.
MUSCLES OF THE HAND
In addition to the tendons of the muscles of the forearm, passing on the back and palmar
sides of the hand, the latter also has its own short muscles,
beginning and ending in this section of the upper limb. muscles
brushes are divided into three groups. Two of them are located along the radial and local
to the left edges of the palm, form the elevation of the thumb (thenar) and the little finger
tsa (hypothenar). The third (middle) group lies in the palmar cavity (palma
Muscles of the thumb.
The short muscle that abducts the thumb of the hand, m. abductor
pollicis brevis. It lies superficially in relation to the rest, next to the long
muscle that abducts the thumb of the hand. Function: takes a big pa-
2. Short flexor of the thumb, m. flexor pollicis brevis. Le-
lives more medially than the previous one and has two heads: superficial and deep,
between which passes the tendon of the long flexor of the thumb
brushes Function: flexes the proximal phalanx of the thumb.
The muscle that opposes the thumb of the hand, m. opponens
pollicis. It lies under the short muscle that removes the thumb of the hand. Funk-
tion: produces opposition of the thumb.
4. The muscle that leads the thumb, m. adductor pollicis. Le-
lives in the depths of the palm distal to the previous ones. Function: leads big
Muscles of the elevation of the little finger.
5. Short palmar muscle, m. palmaris brevis.Beginning of the muscle: from
ulnar edge of the palmar aponeurosis; ends in the skin at the elbow edge
palms. Function: stretches the palmar aponeurosis.
6. The muscle that removes the little finger, m. abductor digiti minimi. Lies on
superficially along the ulnar edge of the hypothenar. Function: retracts, bends and unfolds
little finger bends.
7. Short little finger flexor, m. flexor digiti minimi brevis. lies
along the radial edge of the previous muscle. Function: flexes the proximal
phalanx of the little finger.
The muscle that opposes the little finger, m. opponens digiti minimi.
Covered by the previous two muscles. Function: draws the pinky to
thumb (opposes)
Muscles of the palmar cavity.
9. Vermicular muscles, mm. lumbricales, four narrow muscles
bundle located between the tendons of the deep flexor of the fingers. Starting-
coming from the tendons of the deep flexor of the fingers, go around the heads of the metacarpal
bones from the radial side and are attached on the back of the proximal phalanges to
tendon stretching of the common extensor of the fingers. Function: bend
proximal and straighten the middle and distal phalanges of the 2nd-5th fingers
10. Interosseous muscles, m. interossei. Occupy the spaces between
bones, attaching to them, and are divided into three palmar and four
dorsal muscles. Function: abduction and adduction, flex the proximal
phalanx and unbend the middle and distal like worm-like muscles.
FASCIA AND TOPOGRAPHY OF THE UPPER LIMB
Shoulder fascia, fascia brachialis, surrounds the muscles of the shoulder. From her deep
depart two fibrous intermuscular septa (septum intermusculare
brachii mediale et laterale), which adhere to the scallops of the medial and la-
lateral edges of the humerus and separate the anterior and posterior
shoulder muscle groups. The fascia of the shoulder passes into fascia of the forearm fascia
antebrachii, which, covering all the muscles of the forearm, forms between them
fibrous septa.
In the lower third of the forearm, the fascia on the palmar and dorsal sides is
zuet transverse thickening (ligaments) - the retainer of the flexors and extension -
calves, retinaculum flexorum et extensorum. The dorsal ligament through the development
stkov fuses with the surface of the radius and ulna. Between these
sprouts under the ligament are six bone-fibrous canals through which
rye pass the tendons of the extensor fingers of the hand. In the first channel (counting
from the radial edge) are tendons m. abductor pollicis longus etc. extensor
pollicis brevis, in the second, m. extensor carpi radialis longus and brevis; in third-
m. extensor pollicis longus; in the fourth-m. extensor digitorum and m. extensor
indici; in the fifth - m. extensor digiti minimi; in the sixth - m. extensor carpi ulnaris.
64. Muscles that flex and extend the hand and fingers.
Bend the brush: flexor carpi ulnaris, flexor carpi radialis, superficial flexor digitorum, flexor digitorum deep, flexor thumb longus, long palmar muscle.
Flexor carpi ulnaris starts from the medial epicondyle of the humerus, from the ulna and fascia of the forearm. With its distal end, it reaches the pisiform bone, to which it is attached. Ligaments run from the pisiform bone to the hooked and to the 5th metacarpal bones, which are a continuation of the traction of this muscle.
flexor carpi radialis starts from the medial epicondyle of the shoulder and the intermuscular septum, the muscle passes to the hand under the ligament-retainer of the flexors and is attached to the base of the 2nd metacarpal bone. Being a multi-joint muscle, it participates not only in the movements of the hand, but also in the flexion of the forearm at the elbow joint.
Superficial finger flexor originates from the medial epicondyle of the humerus, as well as from the ulna and radius. It has four tendons that pass to the hand through the carpal canal, located under the ligament-retainer of the flexors, and reach, each splitting into two legs, the lateral surfaces of the middle phalanges of the 2nd-5th fingers, to which they are attached. The function of this muscle is to flex the middle phalanges. Being multi-articular, the muscle also causes flexion in all joints of the hand, except for the distal interphalangeal joints.
Deep finger flexor lies directly on the anterior surface of the ulna and on the square pronator; starts from the two upper thirds of the palmar surface of the ulna and partly from the interosseous membrane. It is divided into four tendons that pass in the carpal tunnel to the distal phalanges of the 2nd-5th fingers of the hand through the splitting of the tendons of the superficial flexor of the fingers. Being a multi-joint muscle, it flexes in all joints of the hand, including in the distal interphalangeal joints. The tendons diverge on the brush in a fan-shaped direction towards the fingers, due to which this muscle not only flexes the fingers, but also adducts them.
flexor thumb longus- a unipennate muscle that has a fusiform shape. It starts from the palmar surface of the radius, passes through the carpal tunnel in a separate synovial sheath and reaches the distal phalanx of the thumb, to which it is attached. The muscle produces flexion in all joints near which it passes (in particular, it flexes the distal phalanx of the thumb).
long palmar muscle is not permanent. Starting from the medial epicondyle of the humerus and from the fascia of the forearm, this muscle is located on its front side so superficially that, when contracted, it is easy to see it under the skin and feel the tendon. Attaching to the palmar aponeurosis and pulling it, with a strong contraction, it can also take some indirect part in bending the fingers.
Unbend the brush extensor carpi radialis long and short, extensor carpi ulnaris, extensor digitorum, extensor thumb longus, extensor digitorum digitorum, extensor index finger.
extensor carpi radialis longus starts from the lateral edge of the humerus, intermuscular septum and lateral epicondyle, passes under the ligament-retainer of the extensor and the tendon of the long extensor of the thumb and is attached to the base of the 2nd metacarpal bone. Due to the fact that the resultant of this muscle passes very close to the transverse axis of the elbow joint, its participation in the flexion of the forearm is insignificant. Being a strong extensor of the hand, it also produces some abduction during isolated contraction.
extensor carpi radialis brevis starts from the lateral epicondyle of the humerus, the fascia of the forearm and is attached to the base of the 3rd metacarpal bone. Being an extensor of the hand, the muscle simultaneously abducts it.
Elbow extensor of the wrist originates from the lateral epicondyle of the humerus, the collateral radial ligament, and the fascia of the forearm. Descending to the hand, the muscle goes between the head and the styloid process of the ulna and is attached to the base of the 5th metacarpal bone. Being an extensor of the hand, the ulnar extensor of the wrist also leads it.
Bend the thumb: long flexor of the thumb, short flexor of the thumb.
Finger extensor originates from the lateral epicondyle of the humerus, the radial collateral ligament, the annular ligament of the radius, and the fascia of the forearm. In the middle of the forearm, this muscle passes into the tendons running under the extensor retainer ligament to the back surface of the proximal phalanges of the 2nd-5th fingers. Each tendon, in turn, has three legs, of which the middle one is attached to the middle phalanx, and the two lateral ones reach the distal phalanx of the fingers.
Long extensor thumb originates from the posterior surface of the ulna and radius, the interosseous membrane of the forearm and is attached to the distal phalanx of the thumb. The tendon of this muscle passes under the extensor retinaculum in a separate canal, crossing the tendons of the radial extensor carpi. Unbending the distal phalanx, the muscle simultaneously pulls the thumb back somewhat. If it is fixed, then the muscle is involved in the abduction of the entire hand.
Little finger extensor starts from the lateral epicondyle of the humerus, radial collateral ligament, annular ligament of the radius and fascia of the forearm, goes down and attaches to the dorsal aponeurosis of the 5th finger. Unbending this finger, the muscle also unbends and somewhat leads the entire brush.
Index finger extensor originates from the dorsum of the ulna and the interosseous membrane. This muscle, with its tendon, merges with the extensor tendon of the fingers, going to the 2nd finger, reaches the dorsal aponeurosis of the index finger and is attached to its distal and middle phalanges. It extends the index finger and also contributes to the extension of the entire brush.
Also in progress finger flexion and extension muscles involved: extensor thumb brevis, worm-like muscles, palmar interosseous muscles, dorsal interosseous muscles, short abductor thumb, flexor thumb brevis, opposing thumb, adductor thumb, short palmar muscle, muscle that removes the little finger, short flexor of the little finger, muscle that opposes the little finger.
Short extensor thumb starts from the posterior surface of the ulna and radius, attaches to the proximal phalanx of the thumb, which it unbends, retracting the entire finger at the same time. If the finger is fixed, then the muscle is involved in the abduction of the entire hand.
vermiform muscles originate from the deep flexor tendon of the fingers. These muscles go to all fingers, except for the 1st. Attached on the dorsal aponeurotic sprains of the proximal phalanges. The function of these muscles is that they bend the proximal phalanges of the 2nd-5th fingers.
Palmar interosseous muscles(there are 3 of them) are located between the metacarpal bones of the 2nd-5th fingers and start from these bones. They are attached to the articular capsules of the metacarpophalangeal joints and to the dorsal aponeurosis of the 2nd, 4th and 5th fingers. By bending their proximal phalanges, these muscles simultaneously bring these fingers to the middle finger.
Dorsal interosseous muscles in the amount of four are located in the intervals between the metacarpal bones. Their starting point is the lateral surfaces of the metacarpal bones facing each other. Reaching the back surface of the proximal phalanges, they are woven with thin tendons into the aponeurotic stretching of the extensor fingers. The function of these muscles is that, by bending the proximal phalanges of the 2nd-5th fingers, they simultaneously contribute to the extension of the middle and distal phalanges of these fingers. In addition, they abduct the 2nd and 4th fingers from the 3rd and tilt the 3rd finger towards both the radius and the ulna.
Short muscle that abducts the thumb, has an extensive place of origin on the ligament-retainer of the flexors and on the navicular bone. Attaching to the proximal phalanx of the thumb, it contributes to its abduction.
Flexor thumb short originates from the ligament-retainer of the flexors and the trapezius bone. This muscle is attached to the sesamoid bone and, by bending the 1st phalanx of the thumb, contributes (due to the tension of the antagonists) to the extension of its 2nd, distal, phalanx. The muscle is also involved in the opposition of the thumb.
The muscle that opposes the thumb to the hand starts from the ligament-retainer of the flexors and the trapezoid bone, and is attached to the 1st metacarpal bone. Its function is that it opposes the thumb to all the others.
Adductor thumb muscle, has two heads - transverse and oblique. The transverse begins from the palmar surface of the body of the 3rd metacarpal bone, oblique - from the base of the 2nd and 3rd metacarpal bones and the capitate bone. The muscle is attached to the sesamoid bone, located in front of the metacarpophalangeal joint of the thumb, as well as to the capsule of this joint and the proximal phalanx of the finger. Its function is that, by bringing the thumb to the median plane of the palm, it contributes to its opposition to the other four fingers.
short palmar muscle starts from the palmar aponeurosis and attaches to the skin. When squeezing the hand into a fist or striking with the palmar surface of the hand, this muscle helps protect the vessels and nerves that run along the ulnar side from the front surface of the forearm to the hand.
Muscle that abducts the little finger begins on the pisiform bone and is attached to the base of the proximal phalanx of the 5th finger. The function of the muscle is to abduct this finger, flex its proximal phalanx, and extend the middle and distal phalanges.
Short little finger flexor originates from the ligament-retainer of the flexors and the hamate bone and is attached to the ulnar edge of the base of the proximal phalanx of the 5th finger. The function of the muscle is to flex it and adduct it.
Muscle that opposes the little finger, begins with the previous muscle, and is attached to the body and head of the 5th metacarpal bone, which it flexes somewhat and brings closer to the middle of the palm.
Muscles of the hand, right (tendons of the superficial flexor of the fingers are partially removed)
1 - flexor retainer; 2 - muscle that removes the little finger; 3 - short flexor of the little finger; 4 - tendons of the deep flexor of the fingers; 5 - muscle opposing the little finger; 6 - worm-like muscles; 7 - tendons of the superficial flexor of the fingers; 8 - muscle that leads the thumb of the hand; 9 - tendon of the long flexor of the thumb; 10 - a short muscle that flexes the thumb of the hand; 11 - a short muscle that removes the thumb of the hand.
Stenosing ligamentitis is a common disease that affects the ring-shaped muscle of the finger, and sometimes affects the feet. The inflammatory process during the disease reduces mobility. In some cases, the enlarged muscle may fuse with nearby tissues.
About the disease
In the common people, stenosing ligamentitis is called "snapping finger". For the most part, the disease is ignored because they are unaware of the danger.
Ligamentitis affects the tendon of the hand or foot. This problem occurs not only in adults, but also in children. Inflammatory reactions occurring in the affected tendon reduce the mobility of the fingers or toes. The number of people facing this problem is growing. Of all patients with hand disease, about 8% suffer from "trigger finger".
The main types of disease:
- Nott's disease. The most common type of problem.
- De Quervain's disease. Damage to the long conductive muscle and short extensor. The disease affects one finger, most often the thumb.
Neglect of treatment leads to complete failure of the finger or foot.
Stenosing ligamentitis is divided into three stages.
Stages of development:
- Stage 1. The finger begins to click, there are slight pains in the damaged area.
- Stage 2. Thickening of the tendon leads to a decrease in the mobility of the finger. Pressure on the injured area causes pain. There is discomfort in the wrist joint.
- Stage 3. The finger remains bent. Only surgery can correct the situation. Surgery is available for children and adults.
It is highly undesirable to start the disease. Identifying the problem, even in the early stages, is easy. You should contact a specialist immediately after the first symptoms are detected.
Causes
Stenosing ligamentitis can be called polyetiological, since the disease occurs due to a number of factors. What influences the development of the disease?
- Gout. The deposition of uric acid in the joint and nearby tissues is the background for inflammatory processes.
- Diabetes. Leads to inflammation of the connective tissues due to the deposition of pathological protein.
- Rheumatoid arthritis. The disease leads to inflammation of the joints of the hand.
- Stable fingers. Ligamentitis, most often, develops in people who perform monotonous work with their hands.
- Heredity.
- Atherosclerosis.
- Incorrect structure of the annular ligament, tendons.
- Injuries.
- Infections.
In most cases, a "trigger finger" occurs when inflammation occurs in the hand or foot. People who work with their hands are especially susceptible to the disease. However, the disease also occurs in children.
At risk are:
- Musicians.
- Welders.
- Jewelers.
- Bricklayers.
- Dentists.
Ligamentitis leads to thickening of the tendon. This interferes with its movement and makes the annular ligament an obstacle. A disease that occurs in children, in most cases congenital, and in adults associated with tissue inflammation.
Symptoms
Trigger finger syndrome has pronounced symptoms. Diagnosing the disease is not difficult even in the early stages.
The main symptoms of Knott's disease:
- Pain near the injured ligament. Appears while moving.
- Swelling above the joint.
- Enhanced sensitivity.
- Finger numbness.
- Pain in the region of the wrist joint.
- Finger flexion problems. Feels like an obstacle.
- The finger does not flex.
- Movement of the wrist joint aggravates the pain.
- Fingers click when moving.
- Low functionality during operation.
- The occurrence of swelling.
- Painful sensations with pressure on the arm.
- Echoes of pain in the shoulder or hand.
- Decreased joint mobility.
All stages of the disease are accompanied by swelling, which brings discomfort when pressure is applied to it. The tendons also harden. At the last stage of the disease, the phalanx thickens. A patient with the final stage of the disease cannot do without surgery.
Symptoms of De Quervain's disease:
- Swelling.
- Pain in the affected tissues.
- The work of the brush does not deteriorate.
- The pain comes from the wrist.
- Discomfort occurs in the shoulder area and fingertips.
This kind of "trigger finger" affects people from 40 years old. Most often, ligamentitis affects women, among them this pathology is more common.
Diagnostics
Trigger finger syndrome does not require special methods for detection. The doctor orders an X-ray and examines you. Examination is necessary to rule out degenerative joint problems that have similar symptoms. This is necessary for the correct choice of treatment.
Palpation of the hand with Knott's disease helps to detect:
- Thickening of the tendon located in the region of the distal fold.
- Clicking.
- A thickening that moves with the movement of the finger.
It is important to know that with a prolonged absence of movement in the injured finger, all symptoms intensify.
Palpation in Kerven's disease helps to detect:
- Painful sensations with pressure in the region of the styloid process.
- Discomfort when abducting healthy fingers. Pain in arm from shoulder to wrist.
Some symptoms, such as numbness of the fingers, occur in each type of disease, so a specialist should make a diagnosis. Immediately after the discovery of the disease, you should abandon the load, and then fix the limb with the affected ligaments and joint.
Treatment
Stenosing ligamentitis can be treated in two ways. For the initial stages of the disease, a conservative method is used, and if the disease is neglected, surgical intervention is used.
Stenosing ligamentitis conservative treatment:
- Electrophoresis.
- Ozokerite.
- Phonophoresis.
- Applications.
- Preparations.
A conservative method, if the disease is not neglected, gives results in a few weeks. During this time, the affected joints, ligaments and muscles of the hand are completely restored. A specialist should draw up a treatment plan. Only a doctor can prescribe drugs.
It is important to know that massage is not included in the list of procedures, as it can aggravate the patient's condition.
At the time of treatment, the patient should avoid any exercise, even the simplest. It is necessary to exclude any work, especially related to the brush. This applies even to cleaning, or embroidery. The recovery time depends on compliance with this requirement.
Conservative treatment is especially effective for children. More than 70% of patients under 3 years of age fully recover.
Surgical intervention
If the conservative method did not have the desired result, an operation will be required. The surgical method involves the dissection of a deformed tendon or annular ligament. The intervention is safe for both adults and children.
Before surgery, during an exacerbation, the patient must follow some recommendations.
Requirements:
- Avoid brush strokes. This will increase the chance of injury.
- The use of drugs that reduce inflammation and pain. Medicines are prescribed by a doctor.
- Tendon injections. Injections are made only by a doctor.
After the inflammatory processes have decreased, and the period of exacerbation has passed, an operation is prescribed. Intervention will help to avoid relapse, as well as loss of working capacity.
In children who underwent surgery before the age of 2, the chance of a complete recovery is about 90%. Doctors perform open surgery. It avoids exacerbations, and also does not damage nerve cells.
open surgery
Surgical intervention in both adults and children is carried out according to the same plan.
Operation steps:
- General anesthesia.
- Dissection of the ligament around the thickening.
- Finger alignment.
- Wound treatment.
- Bandage application.
- Tire installation.
The operation is very simple and has many advantages over other types of treatment.
Advantages:
- Low potential for tissue damage.
- There is no possibility to injure blood vessels, nerves.
- Decompression cut.
- No damage to anatomical relationships.
The brush begins to fully work in a couple of days. The stitches are removed two weeks after the operation.
Closed method operation
Surgical intervention in this way lasts only 20 minutes.
Operation plan:
- Local anesthesia is used.
- A small hole is made.
- The annular ligament is dissected.
- Fingers straighten.
- A bandage is applied.
On the face of it, the operation seems quick and easy. However, this method has several significant drawbacks. Therefore, especially for children, it is advisable to use the open method.
Flaws:
- Potential for flexor tendon injury.
- Possibility of relapse.
- Lack of visual control increases the chance of injury.
- The occurrence of a hematoma.
Choosing the appropriate method should be after consulting a doctor.
Alternative Methods
Folk remedies have a positive effect on the ligaments, muscles and wrist joint.
Treatment methods:
- Warming up. Heated salt is poured into the bag and applied to the damaged area. It is advisable to repeat the procedure several times a day.
- Healing mud. Healing clay is brought to the density of sour cream. Then 5 teaspoons of apple cider vinegar are added to the mass. The gruel must be applied to the injured finger, wrapped and held for about 2 hours. The hand should rest during this time.
- Mix six teaspoons of crushed elecampane rhizome with 1 liter of hot water and boil for 20 minutes. Boil the resulting liquid, apply on paper towels, and then apply to the damaged area.
- Brew pine and coniferous branches in a ratio of 1:3. Boil for 20 minutes, then strain. Apply a wet cloth to the affected area.
- Dissection of the limb. Coniferous oil and sea salt are added to a liter of boiling water. In the process of steaming, you should move your fingers.
- Calendula flowers should be crushed and mixed with baby cream in a ratio of 1:1. The resulting ointment is infused for a day in the refrigerator.
Folk remedies are especially effective in the early stages of the disease. Trigger finger responds well to alternative treatments. Since folk remedies have no contraindications and are suitable even for children.
Gymnastics
Gymnastics can help relieve pain in the wrist joint, ligaments, muscles of the hand.
Exercises:
- Elbows rest on the table, palms look up. Shaking movements are made with the brush.
- Playing an imaginary flute.
- Elbow on the table. Brush rotations are performed.
- Hands at chest level, palms folded together. Alternately, pressure is applied with the fingers of one limb to the other.
- The position is similar. The wrists are spread apart, the fingertips do not come off each other.
Exercise is effective in the early stages of the disease.
Prevention
Finding a "trigger finger" is easy. Therefore, if there is a suspicion of a disease (crunching in the fingers), in adults or children, it is worth immediately reducing the load on the hand. Compresses and light massage will also help. Do not self-medicate, you must immediately contact a specialist.
Do not neglect folk remedies that help with inflammation of the tendons. It is quite possible to cure the "trigger finger", especially at an early age.
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| Joint puncture with the introduction of drugs into the joint in an outpatient clinic (without the cost of the drug) | 1660 rub. | |
| Puncture for hemarthrosis | 2000 rub. | |
| Cast remodeling, shortening of the fixation bandage as part of an outpatient consultation | 940 rub. | |
| Removal of a circular immobilizing dressing in an outpatient clinic | 980 rub. | |
| Removal of the splint any in the outpatient clinic | 740 rub. | |
| Shock wave therapy in the outpatient clinic | 1800 rub. | |
| Taping for injuries and diseases of the capsular-ligamentous apparatus as part of a consultation | 820 rub. | |
| Taping for injuries and diseases of the capsular-ligamentous apparatus without consultation | 1020 rub. | |
| Osteosynthesis with plates for fractures of the bones of the hand, collarbone, foot | 12000 rub. | |
| Osteosynthesis with wires for fractures of the bones of the hand and foot | 3200 rub. | |
| Surgery for Dupuytren's contracture | 12000 rub. | |
| Surgery for stenosing ligamentitis, De Quervain's disease | 9750 rub. | |
| Trigger finger surgery | 9000 rub. | |
| Removal of a Baker's cyst | 9500 rub. | |
| Removal of metal structures (plates) from the collarbone, ankle, bones of the forearm, hands and feet | 12000 rub. | |
| Needle removal | 1500 rub. | |
| Achilles tendon suture (up to 2 weeks from the moment of injury) | 12000 rub. | |
| Achilles tendon suture late after injury (more than 2 weeks after injury) | 14000 rub. | |
| The suture of the tendon of the flexor of the finger in PHO, including PHO on the day of injury | 5600 rub. | |
| Finger flexor tendon suture late after injury (more than 2 weeks) | 12000 rub. | |
| The suture of the extensor tendon of the hand in case of PHO, including PHO on the day of injury | 3200 rub. | |
| The suture of the extensor tendon of the hand, incl. late terms after injury (1-2 weeks) | 8000 rub. | |
| Doctor's consultation at home, primary | 2700 rub. | |
| Doctor's consultation at home, repeated | 2100 rub. | |
| Consultation of the doctor of the leading specialist / head of the department / K.M.N. home, primary | 3300 rub. | |
| Consultation of the doctor of the leading specialist / head of the department / K.M.N. at home, repeated | 2700 rub. |
Why is a tendon rupture in the finger dangerous? The mobility of the hand is provided by the coordinated work of the flexors and extensors. The first are on the palmar surface of the hand, the second - on its back side. Fingers do not have muscles, so their movements are carried out through connective tissues. Flexors can be superficial or deep. Some of them are on the middle phalanges, others are on the nails. Tendon injuries occupy the first place among the injuries of the hands and fingers. About 30% of them are accompanied by complete or partial tendon ruptures. This is due to the special arrangement of tissues, which makes them easy to damage.
Classification
Injuries to the ligaments of the thumb reduce the functionality of the hand by 50%, the index and middle fingers - by 20%. They are most common among people who prefer amateur sports activities. Depending on the presence of skin damage, tendon ruptures are divided into open and closed. The first occur when injured with piercing-cutting objects. The latter are diagnosed in athletes. The tendon is damaged when it is overstretched.
Ruptures are divided into partial and complete, the severity of the injury is assigned depending on the number of torn fibers. Total damage is more difficult to cure. A rupture of one ligament is considered isolated, several - multiple. We are talking about a combined injury in case of damage to muscle tissues, blood vessels and nerve endings.
Important in the appointment of treatment is to determine the duration of damage. A subcutaneous rupture that occurred less than 3 days ago is considered fresh. Injuries that occurred more than 3 days ago are called stale. Those that happened 21 or more days ago are old.
Common causes of injury
Tendon and joint capsule injury can be traumatic or degenerative in origin. The latter type is the result of tissue thinning, the first occurs with a sharp rise in weight. Sports injury can have a mixed origin.
The provoking factors are:
- a short break between workouts;
- lack of warm-up during class;
- reassessment of their capabilities;
- failure to comply with safety regulations.
The risk group includes people who are overweight and the elderly.
Characteristic features
Symptoms of rupture of the ligaments of the finger are determined by its localization. Damage to the tissues located on the anterior surface of the hand is accompanied by a violation of flexion functions. In this case, the fingers acquire an overbent position. When the tendons of the back of the hand are injured, extensor abilities suffer. Damage to the nerve endings can lead to numbness and paresthesia. If at least one of the symptoms listed above appears, you should consult a doctor. Fresh injuries heal faster than old ones.
If a person notices that the functions of the hand are seriously impaired, he should apply a sterile bandage and a cold compress. This prevents hemorrhage and the development of swelling. The limb must be raised above the head, this will slow down the speed of blood flow.
In the emergency room, the initial treatment of the wound is carried out, including the application of antiseptic solutions to the skin, stopping bleeding and suturing. After that, a tetanus toxoid vaccine is given and antibacterial drugs are administered. If a rupture of the extensor tendon of the finger is detected, the patient is sent to the surgeon. Without the operation, the brush may lose its function.
Therapeutic activities
Treatment of extensor tendon injuries can be carried out not only surgically, but also conservatively. However, this does not apply to flexor injury. In case of finger injuries, long-term wearing of a cast or other fixing device is indicated.
Injuries that occur in the wrist area are treated exclusively by surgery. The ends of the torn ligament are sewn together. If the damaged tissues are located in the area of the distal interphalangeal joint, the splint is applied for 5-6 weeks.
A faster recovery of finger functions is observed after the operation "extensor tendon suture".
A fixation device after surgery is necessary to ensure that the joint is in an extended position. You will have to wear it for at least 3 weeks. The splint must be worn on the finger at all times. Its early removal can contribute to the rupture of the scar that has begun to form, as a result of which the nail phalanx will again assume a bent position. In such cases, repeated splinting is indicated. During the treatment period, it is recommended to be under medical supervision.
With boutonniere-type deformation, the joint is fixed in a straight position until the damaged tissues are completely healed. The suture is necessary for reduction and complete rupture of the tendon. In the absence of treatment or improper splinting, the finger assumes a bent state and freezes in this position. It is necessary to follow all the instructions of the traumatologist and wear a splint for at least 2 months. The doctor will tell you exactly when it will be possible to remove it.
Rupture of the extensor tendons at the level of the metacarpal bone, carpal joint and forearm requires surgical intervention. Spontaneous muscle contraction leads to a tightening of the tendons and a significant divergence of the damaged fibers.
The operation is performed under local anesthesia. First, the bleeding is stopped, after which the torn ligament is sutured to the distal phalanx. If the injury is accompanied by a fracture, the bone fragment is fixed with a screw. The needle in the finger plays the role of a retainer.
Surgical intervention is performed on an outpatient basis, after its completion, the patient can recover home.
Recovery period
Rehabilitation for a torn flexor tendon includes:
- massage;
- taking medications.
Rubbing accelerates the process of restoration of damaged tissues, increases their strength. The ligament must be worked out with the fingertips, the load must be increased gradually. Movements are carried out along the damaged section of the tendon. Massage can be started only after the completion of the stage of inflammation. The procedure should not last more than 10 minutes.
Finger development is an important part of rehabilitation. It enhances blood circulation and tissue nutrition. You need to squeeze your hand and hold it in this position for 10 seconds. After that, the fingers are unbent as far as possible and fixed in this position for 30 seconds.
You can not stretch the tendon sharply, you can perform the exercises as often as you like. Do not forget that classes should be regular.
In some cases, anti-inflammatory drugs are prescribed after splinting. However, the inhibition of the inflammatory process can interfere with the normal healing of tissues, which will lead to dysfunction of the hand.
If the pain syndrome does not disappear, it is necessary to stop exercise therapy until the condition of the ligament improves.
How long does it take for a tendon rupture to heal? With minor injuries, recovery takes no more than a month. With a complete break, this period can last up to six months.