Stenosing ligamentitis: treatment

The term stenosing ligamentitis is commonly referred to as a pathological change in the condition of the tendon and surrounding ligaments, which leads to a constantly bent position of the finger (more rarely, several fingers) of the hand. Due to the fact that at the beginning of the disease when the phalanx is extended, a click is heard, it has one more name - a "snapping finger".

History of the study of stenosing ligament

For the first time about this disease in 1850, Dr. Knott mentioned in his works (by the way, later the disease was named after him). He talked about a phenomenon in which patients complain of problems arising when trying to unbend or bend the finger of the hand. And in 1887, Dr. Schoenburn made the first operation, during which he cut the "pathological burden."

Since then, a number of reports have appeared in specialized publications, the topic of which has become stenosing ligamentitis, treatment and ways of diagnosing this disease. And since 1966 the Russian doctor NP Shastin proposed to use the method of surgical operation, which he called a minimally invasive ligamentotomy.

What is this disease?

Stenosing ligamentitis is referred to polyethological (i.e., arising for many reasons) violations of the tendon-ligament apparatus in the hand. It is characterized by the infringement of tendons in the lumens of the fibrous channels, caused by the inflammatory process of the compressive nature in the heavies, which connects the muscles to the bone.

On the hands of each person there are so-called ring-shaped ligaments that hold the bent finger in this position, not allowing it to unwind autonomously. Here, most often, there is a contracting inflammation in the case of Nott's disease . In this case, the ligaments narrow, and the tendon thickens, which in time causes the main symptom of the disease - a permanently bent finger.

Who is most susceptible to the stenosing ligament

Until now, the causes that cause stenosing ligament toes have not been adequately studied. It is generally believed that the underlying cause of this disease is microtrauma and overstrain of the hands, caused by the same forced position for a long time.

This happens mainly in people working at the machine tool, or in 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 masons.

Often, the above pathology and lead to various chronic inflammation of ligaments and joints: polyarthritis, rheumatism, etc., as well as the presence of diabetes.

Some authors argue that ligamentitis is also a hereditary disease. But studies that can confirm or refute this claim have not been carried out.

Disease in children

Stenosing ligamentitis in children is rare. And the main reason for its occurrence physicians called the rapid growth of individual structures and tissues in the hand. That is, the diameter of the tendon in this case increases faster than the lumen of the ring-shaped ligament, which leads to a kind of conflict between them that causes chronic inflammation. It eventually leads to degenerative changes in the tendon-ligament apparatus.

Most often it affects children from one to three years and in most cases on the thumb. Unfortunately, there is still no sufficient explanation for this phenomenon.

Parents may notice that the child can hardly unbend a finger, and at its base there is a small, with a pea, thickening. This should serve as an occasion for compulsory treatment to a specialist, otherwise the disease will lead to a permanent forced position of the finger.

The main symptoms of stenosing ligamentitis

Stenosing ligamentitis has a marked symptomatology: for example, when pressing on the base of a troubling finger, the pain becomes sharper.

• At the finger functionality is reduced.
• Pain, by the way, does not focus only on it, it can give in a brush and even in the forearm.
• At the base of the finger, you can grope for a painful dense cone, and he or one of his joints can swell.
• The finger often grows numb.
• After a prolonged immobility of the brush, the symptoms become especially bright.

And of course, the main feature is a click that occurs every time you try to bend or unbend the affected finger.

Stages of development of the disease

The stenosing ligament of the thumb, as well as of the other fingers of the hand, develops in stages. At the first stage, the clicking and painful sensations do not manifest themselves too often.

But, as soon as to unbend the finger will have to make serious efforts, we can talk about the onset of the second stage of the disease. The tendon at this stage usually thickens, and a bump appears under the disturbing finger.

The last, third stage is characterized by the inability to unbend a sick finger. But to wait for it, certainly, it is not necessary, it is better to address in time to the doctor and get rid of an illness.

Diagnosis

If you suspect a stenosing ligament, you are referred to a traumatologist. The doctor examines the affected hand. In addition, the patient must make her X-ray, which allows you to distinguish the disease from arthrosis or arthritis. Additional tests are usually not required.

In connection with the fact that the described pathology, as a rule, develops very quickly, at the first sensations of discomfort or painfulness when you move your finger, you should consult an orthopedist.

Methods of treatment of stenosing ligament

The treatment involved in the diagnosis of "stenosing ligamentitis" treatment directly depends on the stage of the disease and the general condition of the patient. In the early stages, the use of physiotherapeutic procedures, in the form of electrophotophoresis and phonophoresis with drugs that improve microcirculation, as well as applications using paraffin and medicinal compresses, is recommended.

In a later period and in the event that physiotherapy does not produce the expected results, additional medications are prescribed - these can be anti-inflammatory and analgesic agents. It is very popular to inject hydrocortisone into the area where there is thickening.

The patient is obliged to immobilize the finger. An important condition is the change of work, as well as careful avoidance of traumatic factors.

Stenosing ligamentitis: operation

If the measures taken do not give a proper result, or when the patient seeks help at the third stage of the disease, surgery is indicated to him.

During it, the patient is dissected ligament, which prevents the movement of the tendon. By the method of NP Shastin, this operation is done through a puncture by means of special disposable instruments. This does not require hospital facilities and sufficient local anesthesia.

When an open ligamentototomy is performed, the patient under general anesthesia is made with an incision that does not exceed 3 cm. And then the bundle is dissected. After this operation, the brush is fixed with a plaster bandage.

Each of these operations has its shortcomings and positive qualities, therefore it is only the doctor who can decide how to perform the surgical intervention.

Traditional treatment

Stenosing ligament in addition to The appointed procedures can, having consulted with the doctor, to treat and folk remedies. The most popular of them is the so-called dry heat. To do this, the frying pan is heated by sea or salt, which is then poured into a dense bag of linen cloth. Brush turn the palm up, and put the pouch on it. Such heating can be done twice a day, without supercooling between procedures.

Mud packs are also good, for which any therapeutic clay is diluted to a thick sour cream and added to it 5 dessert spoons of apple cider vinegar. This gruel is spread over a painful finger with a thick layer, top is applied to cellophane. Remove the compress after 2 hours. After that, the hand needs complete peace and warmth.

But remember that when diagnosed stenosing ligament treatment with folk remedies can not give any significant results.