De Quervain's Tenosynovitis
De Quervain's tenosynovitis is an inflammation of the two tendons that run from the back of thumb and down the side of the wrist. The causes of De Quervain's tenosynovitis are unknown, but it has been linked to wrist injury, overuse/repetitive motion, pregnancy and inflammatory arthritis. It is much more common in women than in men, and in people who have diabetes or arthritis. The disease was first identified in 1895 by Fritz de Quervain, after whom it is named.
Symptoms of de Quervain's Tenosynovitis
De Quervain's causes pain, swelling and tenderness over the thumb side of the wrist, and makes gripping difficult. The index finger and the back of the thumb can feel numb, and moving the wrist or thumb can cause a squeaking or creaking sound.
It is also possible for a small bump to form on the thumb side of the wrist. If left untreated, de Quervain's can get worse, with pain spreading up the forearm or down to the thumb.
Treatment of de Quervain's Tenosynovitis
De Quervain's tenosynovitis can be diagnosed through the Finkelstein test, in which the patient makes a fist with the thumb tucked inside, and then bends the wrist toward the pinky finger. If the patient feels pain on the thumb side of the wrist, de Quervain's is likely the cause.
Treatment for de Quervain's tenosynovitis focuses on relieving pain and minimizing swelling through the use of anti-inflammatory medication, corticosteroids, splints and rest. Surgery to make more room for the irritated tendons may be recommended in severe cases.
Flexor Tendon Tear
When muscles contract, tendons pull on the bones, allowing movement to occur. In the hand, the muscles that move the fingers and thumb are found in the forearm. Tendons run from the forearm's muscles through the wrist and into the hand, where they attach to the small bones of the fingers and thumb. The hand has tendons on both its top and bottom (palm). The ones on top, the extensor tendons, straighten the fingers. The ones on the bottom, the flexor tendons, bend the fingers.
Each finger has two flexor tendons; the thumb has one. Because they are stretched tightly as they connect muscle to bone, tears or cuts to flexor tendons can cause them to completely separate, making it impossible to bend the affected fingers.
Signs of a Flexor Tendon Tear
A flexor tendon tear can be caused by a deep cut to the palm side of the fingers, wrist, hand or forearm. It can also be the result of a sports-related injury. Certain sports, including wrestling, football and rock-climbing, can force the tendon to rip away from the bone.
There are also health conditions that weaken flexor tendons, making them more likely to tear. A person with only a partial tear to a flexor tendon may still be able to bend the affected finger, albeit not completely.
Treatment for a Flexor Tendon Tear
Only a partially torn flexor tendon, in which the ends of the tendon are still touching, can heal on its own; a splint is worn to promote healing. For complete tears, surgery, in which the torn ends of the tendon are sewn together, is required. A splint is worn after surgery, sometimes for up to two months, in order for the wrist to heal properly. In both cases, physical therapy is prescribed in order keep the hand functioning properly.
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