Snuffbox

introduction

The Snuffbox, also as Foveola radialis is a small, elongated triangular depression on the Thumb side (radial side) the wrist.
It becomes particularly pronounced if you keep all fingers stretched and the Spreads your thumb.
Because her sniff used to be snuff have added portions into the recess and inhaled from it, it is also called "Tabatière" (French for snuff box).
Him you are important conduction pathways, as the Radial artery (Radial artery) and a branch of the Radial nerve, which sensitively innervates the skin of the thumb on the back of the hand.

anatomy

The tabatière is on its long sides by the Tendons of the thumb muscles limited - by the Abductor pollicis longus muscle (long thumb spreader), den Extensor pollicis brevis muscle (short thumb stretcher) and the Extensor pollicis longus muscle (long thumb extensor).
The ground the tabatière form the side part of the spoke (Radius) and a Carpal bones - the Scaphoid, also as Scaphoid bone designated.
The top, roof the tobacco maker makes that Extensor retinaculum - a firm, connective tissue band under which the Tendons of the extensor muscles of the fingers run away.
The retinaculum extensorum ensures that the tendons of the extensor muscles remain firmly attached to the bone when the hand is moved and do not lift off.

The snuffbox contains the important structures Radial artery, the radial artery, as well as a branch of the Radial nerve, which sensitively innervates the skin on the thumb side of the back of the hand.
The Feel the pulse of the radial artery well.

Appointment with a hand specialist?

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 can find me at:

• Lumedis - orthopedics
  Kaiserstrasse 14
  60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, appointments can only be made with private health insurers. I ask for understanding!
Further information about myself can be found at Lumedis - Dr. Nicolas Gumpert

Thumb saddle joint osteoarthritis

The Saddle thumb joint is through a Carpal bones (Trapezium) and through the base of the first Metacarpal (Os metacarpal I) educated. The thumb saddle joint is directly below the tobacco box.

The function of the thumb saddle joint is to enable the great flexibility of the thumbso that precise movements, such as the Pointed handle to the fingers or the Key handle, possible are.

Under one Thumb saddle joint osteoarthritis one understands you Wear and tear of the cartilage in the thumb saddle joint.
This leads to a painful restriction of movement and to one Reduced strength of the thumb.
Often there is also one swelling or even an externally visible one Deformation of the joint.

You can see one in the X-ray narrowed joint space and bone spikes (Spicules), which are typical signs of joint wear.
Sometimes it can also be used for training free joint bodies in the gap come, which intensify the pain of movement even more.

Frequent causes for an osteoarthritis of the thumb saddle joint previous fractures of the metacarpal bones or the carpal bone, such as rheumatic joint diseases.
Also rarely lie genetic causes which can then lead to a familial accumulation of the thumb saddle joint arthrosis.
Saddle arthritis of the thumb often affects women more often than men.

Therapeutically can occur in the early stages of saddle joint arthrosis anti-inflammatory drugs such as ibuprofen or diclofenac are given and help.
Also Cortisone injections can meanwhile lead to a relief of the symptoms.

If the symptoms increase significantly during the night, a surgery should be considered.
There are various surgical methods that have become established over the past few years.
The most commonly used surgical method is Resection Suspension Arthroplasty, in which a carpal bone (Trapezium) is removed and the thumb using a Tendon loop is "tied up" in the saddle joint.
Then one is important Immobilization of the joint for 4 weeks, as well as a moderate, gradual partial exertion until a full exertion is possible.

As an alternative to surgery, you can also special splints or bandages worn to reduce the mobility of the saddle thumb joint. Often, however, those affected feel severely restricted in their everyday work.

Tendovaginits de Quervain

The De Quervain's tendovaginitis is a Tendinitiswhich occurs mainly in women over the age of 40, which is why it is also called "Housewife's Thumb" referred to as.
Overuse or injury to the tendons leads to swelling and swelling painful compression of the tendons.
Also by a prolonged bending of the hand the tendons can be squeezed and compressed.

In the case of de Quervain's tendovaginitis, the Tendons of the short extensor muscle (Extensor pollicis brevis muscle) and des long thumb retractor muscle (Abductor pollicis longus muscle) affected. Both tendons run in the first tendon compartment on the back of the hand.

The compression of the tendons leads to a Inflammatory reaction of the tendon sheathscausing severe pain below the thumb. These occur mainly when holding or gripping firmly.
Often those affected can hardly move the thumb in pain and there is a visible swelling below the thumb.

The de Quervain's tendovaginitis is initially conservative over a Immobilization of the tendons and a Avoiding painful movements treated.
Special splints or bandages can be worn for immobilization.
Also taking anti-inflammatory pain relievers like ibuprofen or diclofenac can provide relief.

If there is no improvement through conservative treatment methods, you can Cortisone injections helpful, but improper injection can damage the tendons.

If the pain returns and the cortisone injections do not help, a surgery in which the first tendon compartment is split.
This prevents compression of the tendons and reduces pain. The operation can be performed on an outpatient basis.
The hand should be immobilized for about a week after the operation and only then slowly and gradually loaded again. After about three weeks, the hand can usually be fully loaded.