Fast finger

The term rapid finger, also called snapping finger, jumping finger or medically tendovaginitis stenosans, refers to a disease of the fingerstrings that produces an unnatural, jerky movement when the finger is stretched.

The tendons of the fingers are attached to the finger ends like cords. When tensing the forearm muscles, the tendons bend the fingers until they close to the fist. The tendons glide through narrow channels, the so-called flexor tendon sheaths.

The snap finger can be caused by local inflammation or by nodule formation on the tendon itself.
If the tendon sheath increases too much volume, the space available to the tendon for sliding is narrowed.

In patients with a fast-moving finger, the finger tendon no longer slides smoothly and evenly in its tendon sheath.

The flexor tendon can become inflamed when gliding in the tendon sheath. Over time, this inflammation will intensify more and more, the tendon may thicken and small nodules may form, which additionally hinder the sliding movement.
There may also be a thickening of the tendon sheath, reducing its inner diameter.

With a snap finger, the tendon is temporarily blocked in the tendon sheath during extension. Sometimes a corresponding noise can be heard when the tendon crosses the bottleneck and suddenly rushes forward.


Causes of the rapid finger

Which causes exactly lead to a rapid finger is usually not quite clear and it can occur one day for no apparent reason.

It can hit one or more fingers, timing and position may vary.
Some patients report that the snap finger is healed on its own for no reason.
People who suffer from tendonitis and have already been to the doctor for carpal tunnel syndrome, tennis elbow, etc. may have a rapid finger months later.

The snap finger arises as a result of a difference in size between the tendon and the entrance of the tendon sheath.

Symptoms of the rapid finger

  • Stiffness in the finger, especially in the morning.
  • A snapping sound when stretching and the feeling that the finger is shifting.
  • Swelling or nodules at the base of the finger.
  • Finger blocked in bending position, which jerks forward.
  • The snap finger is more common in the dominant hand, especially in the thumb, middle and index fingers. It can also affect several fingers at the same time and both hands.
  • In the morning, snapping is typically more pronounced, when grabbing an object or stretching the finger;
  • if the disease worsens, external forces may be necessary to stretch the affected finger.

Therapy for rapid fingers

In the case of mild symptoms, the problem can sometimes be solved by simple protection.
The doctor may recommend a splint that holds the finger in a neutral position.

Anti-inflammatories from the group of nonsteroidal anti-inflammatory drugs, warm or cold packs and massages can have a symptom-relieving effect.

The doctor may inject cortisone into the tendon sheath.
In some cases, unfortunately, the effect is short-lived and a second injection is necessary.
If two cortisone injections do not bring the desired therapeutic success, surgery may be considered.

The injections are not very useful if the rapid finger has existed for a long time or if there are concomitant diseases, such as diabetes.

Surgery of the rapid finger

The surgical procedure for a snap finger is usually performed on an outpatient basis with local anesthesia (local anesthesia) or regional nerve block.
Through a small skin incision (smaller than 2 cm), the ring ligament causing the snap finger is severed and the tendon is freed. In this way, the free gliding ability of the tendon is restored.

Complications of rapid finger

  • Incomplete extension due to the persistent narrowing of the tendon sheath.
  • Persistent snap finger due to incomplete release of the anterior tendon sheath.
  • Movement difficulties due to excessive release of the tendon sheath.
  • Infection.

Recovery times

In most cases, the finger can be moved again immediately after the operation.
It is quite normal when there is pain in the palm. It is recommended to put your hand up to relieve swelling and pain.

As a rule, the finger is healed a few weeks after surgery, but it can take up to half a year for swelling and stiffness to disappear completely.
If the finger was already quite stiff before the procedure, physical therapies and physiotherapy exercises can help to improve the mobility of the finger.

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