SU852320A1 - Method of treating stenotic tendovaginitis of hand fingers - Google Patents

Description

The invention relates to medicine, namely to traumatology and orthopedics.

A known method of treating stenosing ligamentitis of the fingers of the hand, consisting in the introduction of hydrocortisone under the annular, ligament of the finger or above the ligament [1].

However, with the known method, the treatment time is long (3-4 weeks); in addition, the introduction of a needle into the sub-annular ligament is technically difficult, since even with extensive experience it is not possible to insert the needle into the very narrow space between the tendon and the wall of the synovial vagina once or twice. , which in turn leads to trauma to the tissues and especially the synovial vagina. Introduced hydrozcartisone into the lumen of the synovial vagina causes tissue swelling, which leads to increased pain and restriction of finger movement, in connection with which, on the first day, the clinical picture of the disease worsens and it is often necessary to additionally immobilize the hand.

With the introduction of hydrocartisone, there is a risk of infection, since glucocorticoids reduce the resistance of tissues, and ulcers can also form due to melting of the soft tissues of the palm.

The aim of the invention is to reduce the treatment time and reduce soft tissue trauma.

This goal is achieved by the fact that when implementing the method of treating stenogenizing ligamentitis of the fingers of the hand by introducing a drug into the affected area, papain is used as a drug in doses of 0.2 to 1.0 mg st, and it is injected directly into the annular ligament.

The method is as follows.

On an outpatient basis, after treating the palmar surface of the hand with antiseptics, the annular ligament is palpated, while for better orientation, the patient is invited to rhythmically bend and unbend his fingers. The annular ligament is fixed with the tip of the index finger of the left hand! 0 and papain is injected into the ligament with the thinnest needle in an amount of 0.2-0.5 mg and only in rare cases the dose is 0.8-1.0 mg.

Papain injections are given once or twice 25 times a week, depending on the reaction of the soft tissues. The course is 3-5 injections. After the injection, an alcohol compress is applied to the patients, and from the second day warm baths and a massage of the hand are prescribed.

Example 1. Patient X, 55 years old. Diagnosis; stenosing ligamentitis of the third finger of the right hand. Considers himself ill for 1.5 months, when they appeared with the movement of pain at the base of the third finger of the right hand, and then throughout the finger. When moving, the finger clicks, and this moment is accompanied by severe pain throughout the finger, which is why the patient cannot use his right hand.

The annular ligament of the third finger of the right hand is clearly palpable and sharply painful. The patient received 5 injections of papain in an annular ligament with an interval of 7 days. Single doses in this case were: 0.5-0.5-0.2-0.2-0.5 mg papain. After the third injection, the clinic of the disease completely disappeared, the movement of the finger was restored and became painless. Long-term results tracked over 8 months are excellent.

Example 2. Patient B., 49 years old. Diagnosis: stenotic ligamentitis of the first finger of the left hand. After the injury (the patient fell with an emphasis on the left hand), pains and clicks appeared in the area of the first finger of the left hand, which increased in dynamics, and the patient became disabled

On palpation of the annular ligament of the first finger of the left hand and during its movement, sharp pains are noted. Five injections of papain were made into the annular ligament with an interval of 7 days. Single doses of papain were: 1.0-0.2-1.0-0.5-0.5 mg. The clinic of the disease is completely gone. The result of treatment after 7 months. good.

The proposed method reduces the treatment time to 1.5-2 weeks compared with the known (3-4 weeks) and provides a simple technique for administering the drug and minimal trauma to the soft tissues. This is achieved by the fact that the annular ligament is well palpated in typical places 5 and it can be punctured without special effort, previously fixed through the skin with the index finger of the left hand. When implementing the method, the tendon sheath is not injured at all, since the needle 10 is inserted only into the annular ligament.

The papain enzyme is introduced directly into the pathological focus (ring-shaped ligament) in microdoses. In these doses, the drug causes a slight swelling of the soft 15 tissues within 12-18 hours, so pain after administration of the enzyme does not intensify and finger function does not suffer. Severe decongestant and. the anti-inflammatory effect of the drug provides the removal of re20 active edema caused by trauma to the annular ligament.

Claims (2)

Example 1. Patient X, 55 years old. Diagnosis; stenotic ligamentitis of the third finger of the right hand. He considers himself sick for 1.5 months, when he felt pain moving at the base of the third finger of the right hand, and then all over the finger. When moving, the finger snaps, and this moment is accompanied by marked pains all over the finger, due to which the patient cannot use his right hand. The annular ligament of the third finger of the right hand is clearly palpable and sharply painful. A patient received 5 injections of papain with intervalalol in 7 days for a ring-shaped ligament. In this case, single doses amounted to: 0.5-0.5-0.2-0.2-0.5 mg papain. After the third injection, the clinical picture of the disease was completely gone, the movement of the finger was restored and it became painless. Long-term results, tracked over 8 months, are excellent. PRI me R 2. Ill B., 49 years old. Diagnosis: stenosing ligamentitis of the first finger of the left hand. After the injury (the patient fell with an emphasis on the left hand) pains and clicks in the first finger of the left hand appeared, which increased in dynamics, and the patient became disabled. On palpation of the annular ligament of the first finger of the left hand and in its movement, sharp pains are noted. Five injections of papain were made at the annular link with an interval of 7 days. Single doses of papain were: 1.0-0.2-1.0-0.5-0.5 mg. The disease clinic is completely gone. The result of treatment after 7 months. good. The proposed method shortens the treatment time to 1.5-2 weeks as compared with the known (3-4 weeks) and provides simplicity of the technique of administering the medication and minimal trauma to soft tissues. This is achieved by the fact that the ring-shaped ligament is well palpated in typical places and can be punctured without much difficulty, previously fixed through the skin with the index finger of the left hand. In the process, the tendon sheath is not injured at all, since the needle is inserted only into the annular ligament. The enzyme papain is introduced directly into the pathological focus (ring-shaped ligament) in microdoses. At these doses, the drug causes a slight swelling of soft tissues for 12-18 hours, so the pain after the enzyme is not increased and the function of the fingers does not suffer. Severe and edematous. the anti-inflammatory effect of the drug provides relief of reactive edema caused by traumatization of the annular ligament. The invention of the method of treating stenotic ligamentitis of the fingers of the hand by injecting a medicinal substance into the affected area, characterized in that papain is used as a medicinal substance in order to shorten the treatment time and reduce the trauma of soft tissues in doses from 0.2 to 1.0 mg, wherein it is inserted directly into the ring link. Sources of information taken into account during the examination 1. V. Mikhaylenko. Stenosing ligamentitis of fingers. - “Traumatologists, orthopedics, and prosthetics, M, 1965, No. 5, p. 52-54.