Flicking finger
Synonyms in a broader sense
Medical: Digitus saltans
Spring finger, Tendinitis, Tendovaginitis de Quervain, tendon rubbing, tendon thickening, rheumatoid arthritis, jumping finger
definition
A finger that snaps is usually a disease caused by wear and tear. In the course of wear and tear, the flexor tendon of the hand thickens. The tendons of the hand are connected to the bone by so-called ring ligaments. Their job is to hold tendons to the bone as they flex. As the finger is flexed and extended, the tendon passes under the ring ligament. If the tendon thickens in front of the ring ligament, the ring ligament can only be overcome with increased effort, but then quickly.
Read more on the subject at: Snapping finger in tendinitis
Illustration of quick finger
On the right you can see the typical illustration of a jumping finger:
- Thickened tendon knot
- Ring band
- Flexor tendon
Epidemiology / incidence in the population
One flicking fingers is found more frequently in women than in men. It is particularly common after the age of 60.
Children can also be affected by the disease, which is a congenital thickening of the tendon. The is almost always affected thumb.
If your thumb is affected, we recommend our even more appropriate topic: flicking thumb
root cause
A jumping finger leads to a thickening of the flexor tendon of the affected finger. In most cases it is a wear and tear process. As the tendon quality deteriorates with age, the tendon thickens in places in order to be able to withstand everyday stress.
In addition to the process of wear and tear, spring fingers occur more frequently in combination with rheumatic diseases (rheumatoid arthritis), Dupuytren's disease and pre-existing injuries or tendon tears.
Please also read our article on the subject: Causes of tendinitis
Combination with other diseases
A Jumping finger / flicking finger common with Dupuytren's disease or carpal tunnel syndrome. At the Carpal tunnel syndrome there is also an increase in the size of the flexor tendons of the hand due to wear. This increase in size restricts the space in the carpal tunnel and puts pressure on a nerve (Median nerve), which runs with the tendons through the carpal tunnel, increases. If the pressure is too high, functional disorders of the nerves become noticeable. A typical symptom is the nightly numbness of the first three fingers (thumb, index finger, Middle finger).
A jumping finger is also more common in combination with sugar disorder (Diabetes mellitus) or rheumatic diseases (Rheumatoid arthritis) in front.
You can find more information on our topic:
- Carpal tunnel syndrome
- Dupuytren's disease
- rheumatism
Symptoms / signs of illness / complaints
A jumping finger (digitus saltans) shows itself by the inability to bend the extended finger. When trying to bend, the affected person feels a blockage. The thickened tendon knot cannot overcome the ring ligament. With increasing use of force, a noticeable tension builds up. If the force is sufficient, the tendon knot quickly overcomes the resistance of the ring ligament and the finger bends in a flash. This jumping of the finger can usually be reproduced. Some doctors also speak of a pocket knife phenomenon.
In exceptional cases a finger can fix in a stretched or bent position. This is called a trapped finger.The reason for this is that the tendon knot continues to swell, so that the ring ligament can no longer be overcome. The finger is now caught in a bent or stretched position and cannot overcome the resistance even with maximum use of force. This trapped finger can sometimes come loose again. Since this condition cannot be left for long, the ring ligament must be surgically split at short notice, otherwise there is a risk of permanent functional restrictions. Loss of the full ability to bend or stretch was forced.
Typically, the symptoms are greatest in the morning after getting up. Pain occurs when bending and stretching the affected finger.
A jumping finger often occurs for no apparent cause. In some cases, heavy hand strain is reported in advance.
The typical jumping of the finger occurs when bending.
The actual jumping can be painful, but it can also be painless. If pain is present, it will show up in the area of the metatarsophalangeal joint of the affected finger.
In some cases, the thickened tendon knot can be palpated under the skin when the finger is bent and stretched.
Several fingers can be affected.
also read: Pain in the index finger
diagnosis
The diagnosis can usually be made on the basis of the clinical examination. For safety reasons - in order to rule out alternative causes such as joint wear (polyarthrosis) or bone changes - an X-ray of the hand should be made.
Appointment with ?
I would be happy to advise you!
Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)
In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
In our very economic world in particular, there is too little time to thoroughly grasp the complex diseases of orthopedics and thus initiate targeted treatment.
I don't want to join the ranks of "quick knife pullers".
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You will find me:
- Lumedis - orthopedic surgeons
Kaiserstrasse 14
60311 Frankfurt am Main
You can make an appointment here.
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
For more information about myself, see Lumedis - Orthopedists.
Conservative treatment
A flicking finger does not necessarily have to be treated surgically.
There are various treatment concepts that enable conservative treatment. However, it is important that the symptoms have not progressed too far and that the trigger finger is still in the early stages.
Then, for example, water baths can be carried out.
This is done by the hand five times in a row put in warm water for about five minutes. Care should be taken to relax and protect the hand.
Slight movement of the hand should be done in place of strength exercises. The water can easily be moved back and forth a little. Soap or fragrances complement the hand bath and also ensure a pleasant smell. If the water baths do not help, a cortisone injection can be given.
This is applied to the ring band of the thumb. Means of choice is among others Betamethasonewhich shows its effect after 2 to 5 days.
The injection is carried out using a commercially available syringe:
First, the area above the ring band is disinfected. Then mostly 1ml Solution applied into the ring band with a syringe. The whole thing is of course under Local anesthesiabecause the Cortisone syringe but has a fairly large volume and can therefore cause pain.
The anesthetic is done with the help of a local anesthetic, takes effect after approx. 5 minutes and subsides after a good quarter of an hour. The injection with cortisone can take place in this time window. The doctor checks whether the syringe has actually landed in the ring ligament and not in the tendon next to it.
cortisone has anti-inflammatory effects, and in higher doses also immunosuppressive. An immunosuppressive - i.e. suppressing the immune system - effect does not have to be assumed with such small doses.
If there is no improvement within the next six weeks, a new application can take place. This is done in the same way.
In the event that this application is unsuccessful again, however, a third application should not be used. In this case it is advisable to have one operational approach of the flick finger ponder.
However, the success rate of a cortisone injection with a quick finger is around 85%. Since side effects are hardly to be expected and the procedure only takes a few minutes, this form of conservative treatment can definitely be viewed as an alternative before actually performing an operation.
The cost of a cortisone injection varies greatly and depends on the doctor and body region. A syringe on the finger, including use, normally costs less than 50 €.
Surgery of the flickering finger
If there is no success after conservative treatment, the following remains as "Ultima ratio“- so the last step - still the operation.
A Surgery of the flickering finger However, it is not a particularly large intervention, and can microsurgical and outpatient be performed. This means that the patient can go home immediately after the operation.
However, it should be noted that the finger is bandaged and numb and may hurt slightly. If you have come by car, you should organize a driver for after the operation.
In any case, mental support can make an operation more bearable, even if the procedure is usually only performed with local anesthesia:
After the anesthetic has been injected into the nerve path of the finger, there is a short wait until the sensation disappears from the finger.
Then from the inside of the hand - medically from "palmar“- a small cut is made at the level of the ring band. The ring ligament is, so to speak, the guide for the finger tendon. Anyone who has ever laid a power cable in the room knows the small cable clamps with which the cable can be properly attached to the wall.
The tendon runs along the bone in a very similar way, with the cable clamps being the ring ligaments in this case. During the operation, the ring ligament is now split. As a result, the tendon has more play and no longer gets caught on the ring ligament.
Of course, you can't do this with several ring ligaments on one finger, otherwise the tendon would completely detach from the bone.
However, splitting a single ring ligament relieves the complaints of a jerky finger relatively reliably. Surgeons even speak of a 100% freedom from symptoms - another 14% more than with conservative therapy.
After the ring ligament has been split, the skin is closed again at the operated site and a suture is provided. The skin incision is only 1-2 cm small, but you should pay attention to a particularly good cosmetic result in exposed areas such as the hand.
Therefore, the seam is usually sewn with 3-4 stitches, i.e. set particularly tight.
After the operation, the finger must be spared and is provided with a splint and bandage. The initial swelling can still cause pain in the first few days after the operation, but this will subside within the first week. The seams can be removed after approx. 10 days. This can also be done by the family doctor and does not necessarily have to be done in the hospital.
Many surgeons, however, insist on wound control "iyour own“OP.
You can find a lot more information on this topic at: Surgery of the flickering finger
Pain after the operation
In the first few days after the operation, the swelling of the finger can still cause pain.
Swelling is unavoidable as it is the body's own reaction to supposed tissue damage.
However, it can get through anti-inflammatory drugs be contained. Painkillers like Ibuprofen, or Diclofenac conveniently have an anti-inflammatory component at the same time, so these agents are the means of choice for pain after the operation. (see also: post-operative pain)
In addition, the finger should be raised as high as possible to facilitate the drainage of tissue fluid and blood from the finger.
The pain usually goes away with the swelling within a week. Unnecessarily, many patients are afraid of pulling the sutures: If you involve the patient in a conversation and pull the sutures on the side, they often don't even notice.
Pain can only occur if the seams have grown in, which can be the case after more than two weeks. But even then there are ways to take the pain away from the patient.
Snapping finger on the middle finger
A snapping finger typically occurs on the thumb. (please refer: flicking thumb)
But the middle finger can also be affected. However, the therapy does not differ significantly from that of the thumb:
The conservative treatment provides warm water baths in the initial stages. If this is unsuccessful, a cortisone application can be undertaken.
An operation can also be carried out directly, there is no specific scheme. Of course, you always try to use surgery as a last resort.
The operative intervention on the middle finger is carried out - as with the thumb - from the palmar rather than the palm of the hand. Since the affected muscle tendon runs on the palm of the hand, this approach is the easiest. The rest of the procedure is similar to that of an operation on the thumb.
The success rate after surgical treatment is also almost 100%. After the thumb, the middle finger is the second most frequently affected “flick” finger. Incidentally, women are more likely to be affected by a flick of the finger than men. The reason for this is not known, however.
The jumping finger
Synonyms in a broader sense
Medical: Digitus saltans
Spring finger, tendinitis, De Quervain's stenoscopic tendovaginitis, Tendon rubbing, tendon thickening, rheumatoid arthritis, jumping finger
definition
A jumping finger is usually a disease caused by wear and tear. In the course of wear and tear, the flexor tendon of the hand. The tendons of the hand are connected to the bone by so-called ring ligaments. Their job is to hold tendons to the bone as they flex. As the finger is flexed and extended, the tendon passes under the ring ligament. If the tendon thickens in front of the ring ligament, the ring ligament can only be overcome with increased effort, but then quickly, which is perceived as jumping (jumping finger)
Conservative therapy
In the early stages of the disease (jumping finger) can through a syringe containing a small amount Cortisone applies a local anesthetic to the thickened tendon, the swelling of the tendon can be achieved. This will make the symptoms disappear (see above).
Most often the therapeutic success is the Cortisone injection but only of a temporary nature. As the tendon tissue swells again, the problem recurs.
Furthermore, when setting the syringe, strict care must be taken not to inject the cortisone directly into the tendon, as this promotes a tendon tear. With every cortisone injection there is an increased risk of infection, so the indication for injection should be People with sugar (diabetes mellitus) be taken particularly carefully.
In addition, a decongestant from the group of NSAIDs (notsteroidal A.ntirheumatika) like Diclofenac (Voltaren) or Ibuprofen be taken to help reduce swelling.
Movement exercises (Physiotherapy / physiotherapy) help to achieve freedom from symptoms. Exercise in the water bath can also help alleviate the symptoms.
Operative therapy
A lasting success (jumping finger) promises the operative splitting of the ring ligament.
This small outpatient surgery can be performed under local anesthesia. The surgeon can split the ring ligament through a small skin incision, which is usually made in the area of the palm of the hand above the base joint. This removes the obstruction to the passage and eliminates the problem. During the surgical procedure, care must be taken that neither nerves nor blood vessels are injured, so that no circulatory disorders or numbness of the affected finger remain.
In rare cases, the ring ligament can heal again. As a result, the jumping / flicking finger can return. In these cases one speaks of a Relapse (recurrence of the disease). In this case, the desired surgical result can only be achieved through a new operation.
