Stenosing ligamentitis

Stenosing ligamentitis is a pathology which develops in a tendinous ligamentous apparatus (in ring-shaped ligaments situated in fingers). Main symptoms of its development are regular “clicking” in the wrist, peculiar “jamming”, “blocking” of the hand’s finger in the bent and unbent position.

Reasons of the disease:

• Professions connected with hand work (typing, driving, packing etc);
• Hard physical work (load on hands);
• Constant ligament compression;
• Hereditary factor.

Beside outer factors the reason of stenosing ligamentitis can be an inflammatory process in the organism which is connected with muscular skeletal apparatus (arthritis, arthrosis, osteoporosis, osteoarthritis).

Treatment of stenosing ligamentitis

Under regional and conduction anesthesia dissecting of the ring-shaped ligament (which thickens and blocks flexor tendon of a finger) is performed. Because of this a patient feels “clicking”. After surgery a patient can easily move with hand fingers.

Сarpal tunnel syndrome

Carpal tunnel syndrome is a neurologic disease which is characterized by pain, feeling of numbness and pricking in a hand and hand fingers and appears as a result of compression of a median nerve in a wrist canal.

Main reasons of the deasease

Any factors which cause constriction of the wrist canal, its swelling and delay of the liquid can be reasons of the syndrome.

Main reasons are:

• Hormonal changes
• Obesity
• Diabetes mellitus
• Acromegaly – extension of joints as a result of disorder of hypophysis function
• Activity decrease of a thyroid gland
• Kidney failure
• Alcohol abuse
• Amyloidosis – laying of abnormal proteins in tissues and organs
• Rheumatologic arthritis and gout
• Paget’s disease – chronic disease of bones which are deforming
• Deformity of wrists after fractures

Treatment

This disease is characterized by extension of the retinaculum (capsule) around the tendon and median nerve which causes wrist numbness and pain. Surgery is performed under conduction anesthesia. During the surgery dissection of the retinaculum and tendon and nerve release takes place. Once the surgery is performed, a patient is able to move a hand.

Dupuytren’s contracture

Dupuytren’s contracture is condition when palmar aponeurosis of the wrist is hurt (the joint loses its functional possibilities partially or totally). Dupuytren’s contracture develops slowly and in separate cases is accompanied by painful feelings and itching. Palm fascia of such patients becomes thicker and shorter which results in the tendon damage and creation of subcutaneous taenia.

To evaluate the deformity stage of the wrist movement defect the following classification is used:

• Stage I - bending of hand fingers is up to 35°
• Stage II - up to 90°
• Stage III - up to 135°

To choose treatment technique our doctors take into account individual peculiarities of a patient organism, define the reason of the contracture development.

Main reasons of the disease

Most widespread reasons of the disease development are:

• Deformity or another acquired pathology of the joint
• Inborn disorders of bones and joints structures
• Traumas: fractures, dislocations, burns, frostbites
• Inflammatory process in the joint cavity
• A distinct pain syndrome
• Long disorder of blood supply of the extremity
• Cicatricial formation as a result of traumas
• Reduce of tendons with formation of commissure after inflammation (tendovaginitis) or injury
• Muscles reduce as a result of muscles pathology, traumas

Treatment

Under local anesthesia dissection of aponeurosis is performed with special needles, and total unbending of a finger is reached. After the surgery a finger is fixed in a special orthosis for several days. Such surgery allows a fast return to a routine life without rehabilitation.