In order to understand the different therapeutic options for a finger that is moving quickly, it is necessary to first understand the cause of the finger moving quickly. A quickening finger (also known as digitus saltans) is caused by a thickening of the flexor tendon of a finger. There are several reasons for this.
The flexor tendon is guided by a band (so-called ring band) close to the bone. If this tendon is now thickened, it can no longer glide evenly along the ring band when the finger is bent, but initially remains behind and later slides through abruptly, which leads to the quick finger. One also speaks of tendovaginitis stenosans, i.e. a stenosing or constricting tendosynovitis.
Therapy in general
The aim of the therapy of a fast finger is to restore smooth gliding of the flexor tendon along the ring ligament. To achieve this, the thickening of the flexor tendon must be removed.
Therapy – conservative options
Before patients undergo surgery with a quick finger, they should try to reduce the swelling of the thickened flexor tendon using conventional measures. This can be attempted by immobilizing the affected finger in a splint for a few weeks (usually 4-6 weeks). This will cause the tendon to swell.
However, there is always the risk of stiffening of the joint if it is not used for a long time. In addition, an attempt can be made to inject cortisone into the – usually inflammatory – thickened region (cortisone injection). The cortisone inhibits inflammation, but also causes direct swelling of the affected flexor tendon.
Alternatively, a local anaesthetic can be injected, which also has a decongestant effect and also relieves the patients of the pain often associated with a quick finger. Some physicians also combine the two drugs. With this therapy option, it is important to absolutely avoid the carry-over of skin germs into the tendon sheath.
This is made possible by the doctor working as sterile as possible. In addition, other diseases and a skin infection in the area of the affected finger that speak against cortisone therapy should be ruled out beforehand. The effect of the cortisone occurs in about two days after administration, but it may take a few days before the full effect is felt. After about six weeks cortisone can be injected into the affected region again. Often the cortisone injection only leads to a temporary improvement.
