snap fingers

Schnappfinger: Description

Tendovaginitis stenosans can occur on all flexor tendons of the fingers. Most commonly affected by tendonitis are the most stressed fingers, so middle finger and thumb (“quick thumb”), but also the ring finger. If the affected finger is flexed, it initially remains in the bent position and can only be stretched with increased strength or with the help of the other hand. As the name says Schnappfinger, then creates a clearly visible snap, which can also be painful. This phenomenon is called a fast finger or spring fingers.

Another type of tendonitis in the hand is Tendovaginitis stenosans de Quervain. It only affects the extensor tendons in the first tendon compartment on the wrist.

Schnappfinger: causes and risk factors

The Schnappfinger is a common disease – about 28 people per 100,000 population sufferers each year from a Tendovaginitis stenosans. The risk of developing a snap finger during life is around 2.6 percent. In diabetics, the probability is even increased to ten percent. Women are particularly affected: They get about six times more likely a “quick finger” than men.

The first description as tendonitis under the name Tendovaginits stenosans was made in 1850 by Notta. Schnappfinger: causes and risk factors

In tendinitis stenosans, the flexor tendon of the affected finger is thickened like a nodule at the level of the metacarpophalangeal joint. As a result, the tendon can no longer freely slide through the tight ring band (the so-called A1 ring band), which attaches the tendon sheath (in which the tendon runs) to the bone. As a result, the affected finger can often only be bent or stretched in a jerky manner (snap-on phenomenon).

In many cases, the cause of the Schnappfinger remains unknown. Otherwise, chronic overloading of fingers and hands is a frequent cause, for example at work. Also, inflammatory diseases such as gout, rheumatism and metabolic diseases such as diabetes mellitus are considered as a reason for a Tendovaginitis stenosans considered.

There is also a congenital form of the snap finger, namely an innate bent thumb (Pollex flexus congenitus). The affected children are already born with a thickened thumb flexor tendon.

Schnappfinger: Symptoms

The swelling can be different pronounced, so that the symptoms of Schnappfinger can be different strong. At the onset of the disease, patients often describe stiffness of the affected finger, especially in the morning. In most cases the “tendon knot” can be palpated at the level of the hands of the middle hands. One can then feel a pressure-painful swelling which is displaced with the flexor tendons. Nonspecific pain and a feeling of tightness can accompany the Tendovaginitis stenosans.

In the advanced stage of the disease, the typical snap-on phenomenon occurs occasionally or constantly: Due to the knot-like thickening, the tendon can only glide through the ring band with increased force and then suddenly (“rapidly”), which is not necessarily associated with pain. The snap phenomenon often occurs when trying to stretch your finger. If a rheumatic disease is behind the snap finger, flexion is more likely to be blocked.

If the Tendovaginitis stenosans progresses, the affected finger is occasionally or constantly pinched in flexion. Only in pain can he be stretched actively or passively (with the help of the other hand), whereby – and eventually not at all.

The pain in a snap finger is felt not only at the site of movement inhibition, but also stretch side over the joints.

Schnappfinger: examinations and diagnostics

The Schnappfinger can be diagnosed purely clinically. Passive finger movement usually shows a quick thumb or a quick finger, especially in the morning. Patients also often report pressure pain in the area of ​​the ring band, which increases as the finger moves. On the palm, a knot may sometimes be felt on the metacarpal head. In some cases, the Tendovaginitis stenosans can also be considered in the ultrasound in more detail.

Schnappfinger: Treatment

A fast-moving finger is often treated conservatively in the early stages. However, success is usually only temporary, so that surgery is often performed.

Schnappfinger: Physiotherapy & Co.

In the context of conservative treatment, anti-inflammatory drugs can be used, such as anti-inflammatory ointments or cortisone injections. The affected finger may be immobilized for some time. The swelling and pain can often be alleviated by local cooling. After the symptoms have resolved, gentle exercises under physiotherapeutic guidance can be helpful.

Fast finger: OP

To operate the Schnappfinger, usually only a local anesthesia is necessary. The surgeon makes a small incision and then splits the first ring band on the affected finger in the longitudinal axis. Furthermore, if necessary, it will remove inflamed tendon gliding tissue. The surgeon then checks to see if the tendon is free to slide before suturing the wound.

Schnappfinger surgery: complication

The most common complication of surgical Schnapferinger therapy is that the adjacent vascular nerve bundle is injured. The surgeon will pay special attention to the superficial branch of the radial nerve (Ramus superficialis nervi radials).

Schnappfinger: Disease course and prognosis

The surgery usually eliminates the snap fingers, Exercises to mobilize the fingers should be started soon after surgery to avoid adhesions.