Tendinitis

In the case of tendinitis, hand surgeons can usually identify overuse of the corresponding tendons as the cause.

This is caused by repetitive activities that are monotonous, incorrect posture and overloading. This means that it is usually a non-bacterial inflammation in the sense of an irritation.

However, it can also occur in the context of bacterial colonization, e.g. in the case of injuries.

The distinction between purulent and non-purulent tenosynovitis is extremely important, as treatment at Hand Surgery Düsseldorf is fundamentally different.

In the purulent form, bacteria can rapidly enter the bloodstream via tendon sheaths and lymph channels and lead to blood poisoning.

The symptoms of tenosynovitis are characterized by the following points: Pasty swelling, pain, redness, induration, hyperthermia. Pressure pain over the swelling and pain on movement and exertion are typical symptoms.

Furthermore, friction or crunching can be felt when moving the affected tendons.

Sometimes, especially in cases of chronic tendinitis, our Düsseldorf hand surgery team can feel nodules and hardening. Restricted movement, immobility and deformities are usually found in combination with rheumatism.

The pain must be differentiated from discomfort in the joint. Overlegs are also found in connection with tendon sheath inflammation. These can originate in the tendon sheath or in the joint.

Tendon sheath inflammation can cause other diseases.

• Tendon sheath inflammation is often accompanied by nerve compression. A typical consequence in the hand is carpal tunnel syndrome or sulcus ulnaris syndrome in the elbow area. The rare tarsal tunnel syndrome sometimes occurs in the foot.
• Severe consequences of rheumatism:
  Tendon sheath inflammation in rheumatism often takes on severe characteristics. Swelling of the tendon sheaths and joint structures, stretching of ligaments, joint capsules and misalignment of tendons lead to deformities of the fingers and hand.

In the case of tendinitis, overuse leads to increased friction in the area of the tendon sheaths. This leads to irritation of the tendon sheaths with swelling. The latter in turn aggravates the friction and so on.

Friction on structures such as ligaments (annular ligament: snapping finger; extensor tendon compartments e.g.: Tendovaginitis de Quervain = housewife’s thumb; transverse wrist ligament: carpal tunnel syndrome, = CTS) and other tendons in turn lead to an increase in irritation.

As hand surgeons know, micro-injuries also exacerbate tendovaginitis. In chronic, advanced disease, a decrease in tendon gliding ability results from scar-like changes to the tendon sheaths.

This can lead to tendon adhesions and ultimately to a restriction of the range of motion.

The principle of tendonitis surgery is simple.

Thickened tendon sheaths, overlegs, adhesions

Our hand surgeons remove the swollen, thickened tendon sheaths or at least part of them. Any additional excess bone is also removed. We loosen adhesions that may be present if the disease has been present for a long time.

In doing so, we protect the important neighboring structures such as nerves and vessels.

Carpal tunnel

In the case of carpal tunnel syndrome or constricting inflammation, we have to cut the corresponding ligaments (see the respective chapters).

Rheumatism

In the case of rheumatism, the operation is usually more complex. Our hand surgeons often have to correct the position and tension of tendons and ligaments.