THUMBS

Fingers - This final section of the brush. All the fingers are denoted by Roman numerals and are named: I - thumb, II - index, III - medium, IV - ring, V - the little finger. On distinguish finger back, hands, inner and outer surfaces. On the back surface of the nails are.

Bone fingers (except the thumb) comprise three phalanges (closer to the hand - the proximal and then the average, final - distal) interconnected interphalangeal joint. Thumbs have two phalanges (proximal and distal). Grounds proximal phalanges articulate with the heads of the metacarpal bones of the hand, forming the metacarpophalangeal joints.

The skin of the palmar surface of the finger contains a large number of sweat glands. Hair and sebaceous glands on the surface is not. Subcutaneous tissue divided connective webs of fingers extending from the skin to the periosteum of the phalanges. The skin back surface is thinner in the middle and proximal phalanges is covered with hair.

The bone phalanges attach tendons - superficial and deep flexor digitorum. The thumb has its muscles: short and long flexors. Extensor digitorum: common extensor for the middle and ring and individual - for the thumb, index and little finger.

Traumatic dislocation of the fingers

Traumatic dislocation is called a total displacement of the articular ends of bones, resulting injury and accompanied by rupture of the joint capsule and ligaments. Subluxation or dislocation is called an incomplete partial displacement of the articular surfaces.

Sprains usually occur after indirect injury or sudden strong muscle contractions. Sprained considered to be peripheral (distal) part of the limb. There are fresh (the first 2 days after the injury), stale (3-4 weeks), chronic (after 4 weeks), nevpravimye (in contact between the articular surfaces of the soft tissues), habitual (constantly repeated), indoor and outdoor (with no damage or injury to the skin), complications (fractures, damage to blood vessels and nerves) and uncomplicated dislocations and subluxations.

Dislocations fingers are rare .  The most common of these is the dislocation of the thumb metacarpophalangeal joint .  There are a dislocated thumb to the back surface, to palm outwards .  Thus there is a shift of the proximal phalanx to the rear of the brush .  Such dislocation may occur as a result of strong dramatic extension of the thumb on the hand in the fall, while the proximal phalanx slides on the rear surface of I metacarpal bone, and its head is included in the gap on the palmar surface of the capsule ("the trigger gun") .  This situation is accompanied by a spring catch - light springy resistance when passive (made with the other hand or another person) motion in joints .  The proximal phalanx is almost at a right angle with respect to the metacarpal bone, distal phalanx is also bent at the same angle on the palmar surface can be seen and test the I metacarpal bone head .

Diagnosis and treatment of dislocation of fingers

Diagnosis of sprains Dislocation - Prevention and Treatment   fingers is not difficult, since the injury has its own peculiarities. However, be sure to do X-ray hand, since it is necessary to clarify the nature and eliminate the dislocation fractures in this area.

Reduction of dislocation is usually carried out by the closed method under local anesthesia .  The affected phalanx impose a loop of ribbon (its width is almost equal to the height of the injured phalanx) and pull along the rest of the phalanx of fingers .  Simultaneously pererazgibayut finger in the metacarpophalangeal joint and produce pressure on the head I metacarpal bone in the opposite (rear) side .  Once the articular surface of the proximal phalanx of the thumb glide on top of the metacarpal head, trauma surgeon flexes sprained thumb in metacarpophalangeal joint .  In this position, imposed a plaster cast from the elbow to the middle of the nail of the thumb and metacarpophalangeal joints of the other fingers .  After three weeks, the plaster is removed and the prescribed rehabilitation treatment in the form of therapeutic exercise, massage and physical therapy .  Efficiency is reduced by 1-1, 5 months after the reduction of dislocation .

Remember themselves reduce a dislocation can not in any case: it can greatly complicate the condition of the victim.

Galina Romanenko

Protective reflex

Sometimes the cause of the pain is persistent reflex muscle spasm, which is protective in nature, protected from physical impacts bones, nerve trunks, blood vessels and internal organs in various diseases. If this does not remove the spasm in time, it may occur a persistent change in muscle violation of their functions.

Musculo-tonic syndrome or reflex - it is a long and persistent tension (spasm, hypertonicity) muscle formation in these painful seals, which are called trigger (start) point. Muscle itself thus shortened and compacted, reduced the volume of its movements. When pressed on the trigger points show signs of muscular-tonic syndrome in the form of pain that spread over large areas of the body (such as a sore lower back, back, neck, arm or leg).

Muscular-tonic syndromes occur because included reflexes to protect the affected area of ​​the spine (eg, protection from the pain that arises in response to stimulation of the nerve roots in osteochondrosis) muscles that normally do not provide movements at the site, but connected it with the protective purpose .

Appears stiffness characteristic (sign boards or string) when the waist is fixed in a state of deformation by limiting the mobility of the spine in the affected area. As long spastic muscle blood circulation, gradually appear degenerative changes (changes in the exchange in the form of the withering away of the muscle cells and connective tissue replacement of muscle). These muscles begin in themselves cause pain, further aggravating the situation.

Muscle spasm causes curvature of the spine, and even more nerve compression (enhanced pain) and blood vessels (tissue nutrition suffers). The more irritated nerve, the more muscle tension and, therefore, more nerve irritation (pain increases). At the same time the patients themselves restrict movement to avoid pain.

The most common cause of musculo-tonic syndrome is low back pain Osteochondrosis - learn how to properly distribute the weight . The sources of pain impulses in this disease may serve as a stimulation of pain receptors of the intervertebral disc, spinal ligaments, capsules, intervertebral joints, emerged at high physical exertion or a sharp turn of the trunk, and so on. Muscle spasms often occurs in paravertebral muscles and muscles located in the gluteal region and in the neck area.

Signs

The main symptom is pain in the spastic muscles, which are determined at a palpation painful muscle seal (trigger points). The pain can vary in intensity from mild to very severe. Often they give to interested end (not at the same time reaching the foot or hand - this is different from muscle pain pain along the nerves) and amplified by prolonged forced being in the same position, with physical exertion after exposure. Reduces pain rest, physiotherapy, massage, warming procedure.

If the musculo-tonic syndrome squeezed adjacent nerves and blood vessels, decrease in sensitivity may occur, cold and weakness in the limbs concerned.

Musculo-tonic syndrome can develop suddenly, due to heavy lifting or sharp turn of a trunk. This is often a kind of click - displacement of the vertebrae, intervertebral disc rupture the capsule to form a herniated disc Intervertebral hernia - when the body fails . It is accompanied by severe pain, persistent involuntary patient takes a position in which it found injury (for example, can not straighten).

Musculo-tonic syndrome - a complex protective reflex, which can itself become a disease, if the patient is not adequately provided timely assistance.

Galina Romanenko