Cause
The jumping finger is in most cases due to wear and tear and occurs more often in advanced age. The wear and tear leads to a thickening of the flexor tendons of the hand. This makes it more difficult for the tendons to slide through the ring ligaments of the finger when it is stretched or flexed.
The ring ligaments ensure that the tendons remain in contact with the bone when the fingers are bent. If the tendons are thickened in front of a ring band, the tendon can only pass it with greater force when bending it, which manifests itself as the typical jumping of the finger. Another term for this jerky jumping is the pocket knife phenomenon.
The cause of the thickening is not yet fully understood, predisposing factors are not only a higher age but also a congenital disposition, stressful activities or injuries. Often a jumping finger occurs as an occupational disease in certain occupational groups such as craftsmen, sportsmen or piano players who put a lot of strain on their fingers and hands over years. Likewise, unaccustomed intensive strain such as gardening can lead to overexertion and thickening of the tendons of the hand.
The intensive strain on the tendon causes tiny injuries to the tendon, which become more frequent and can lead to persistent inflammation. A thickening of the tendon follows. The phenomenon of the jumping finger is often associated with rheumatic diseases or carpal tunnel syndrome.
Diagnosis
The diagnosis of a bouncing finger is usually made by the doctor during the clinical examination. In order to rule out other diseases requiring treatment, such as bony diseases or joint degeneration (arthrosis), it is recommended that an X-ray be taken.In rare cases, a sonographic examination of the soft tissue with an ultrasound machine or a sectional image procedure can also be used to diagnose or exclude other diseases.
Therapy
The therapy of the jumping finger consists of restoring a smooth gliding of the finger tendon through the conductive ring bands. However, before surgical treatment is indicated, an attempt should first be made to achieve healing with conservative measures. Swelling of the thickened tendon can be reduced by immobilizing the affected finger with a splint.
The finger is splinted for four to six weeks and the swelling of the thickened tendon is reduced due to the lack of load. However, there is a risk of stiffening of the joint with this treatment, which in the long term can lead to restrictions in movement and function. Another therapy option is local cortisone therapy.
For this, cortisone is injected into the affected finger, where it takes effect after one or two days. Cortisone has an anti-inflammatory effect, directly reduces swelling and relieves pain. As a result, the symptoms of those affected improve within a few days, although the full effect of the cortisone can only develop later.
Similar effects can also be achieved with the help of a local anesthetic, which is why it can be applied in combination with cortisone or alone. Often, however, the injection of cortisone does not provide lasting relief, as the symptoms may return with the drug’s effect waning. The triggering factors such as playing the piano, sports and manual activities should be temporarily reduced until the symptoms no longer occur.
If the thickening is already so pronounced that the desired effect cannot be achieved with the cortisone injection, or if the symptoms return after several injections of cortisol within a few months, surgical intervention is indicated. It is a minor procedure that is performed under local anesthesia (local anesthesia) and on an outpatient basis (without hospitalization). The duration of the operation is only a few minutes, ideally the surgeon is specialized in hand surgery.
A small incision is made on the flexor side (inner surface) of the affected finger and the constricting ring band is completely cut through. Special attention must be paid to the protection of parallel blood vessels and nerves. The incision is then sutured with a few incisions and a bandage is applied.
After the anesthesia has worn off, the finger is now freely movable again. The free movement of the finger is restored after the anesthesia has worn off. Post-operative physiotherapeutic exercise treatment is only necessary in rare cases.
Depending on the suture material used, they only need to be removed after about ten days. The healing chances of this surgical procedure are very good, so that almost all patients are relieved of their complaints and can move their finger freely again immediately after the procedure. Cutting the ring band does not usually cause any restrictions, as its function is taken over by the other ring bands of the corresponding finger. Only in exceptional cases do complications such as infection, allergic reactions to the anesthetic, excessive scarring or nerve or vessel injury occur.
