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Muscles in the Hand and Fingers

The system of muscles in the hand and fingers of a human by far in the world of biology is the most well developed structure in the animal kingdom. The human hand can perform any possible movement and the fingers alone are capable of producing tremendous amount of strength. But for all we know, we may always use fingers every day and despite the amount of force the human finger can apply, there are actually no muscles that can be found within the fingers. Our five fingers do not have muscles, it is simply a group of bones cloaked with skin, but we are able to move them because of a number of reasons. Basically, our ability to move our fingers is not as direct as it may seem, because our fingers do not have muscles, there motion in other words is controlled by another set of muscles that are not found in the fingers themselves. In fact, the muscles that control the finger’s ability of motion are found in the hand and also on the forearm.

Muscles in the Hand and Fingers

The cloaked bones of our fingers are connected to the muscles of our hand and arm through thin strings called as tendons. Tendons are the basic structures that are responsible for the motion of our fingers, a damage tendon can result to numerous diseases like trigger finger which will lead to the inability of a finger to move, just an example of how vital the tendon’s role are. The tendons act like strings for our fingers which are controlled by the muscles in our hand and arm, as we flex, the string is pulled resulting to the motion of our fingers. The strength of our fingers in short are determined by the strength of the muscle in arms, which makes grip exercise devices just the same as working out with dumbbells. Without going to much deeper technical terms, the tendons of the fingers can be grouped into two, the intrinsic and the extrinsic. The extensors are the long muscles that are located starting from the forearm to the fingers. Their main role is to perform the straightening of the fingers, while the intrinsic muscles are shorter ones compared to the extensors. The thumb is composed of a number of tendons which gives it the ability of grasping. Other fingers do also have addition tendons which gives the ability of fingers of further movement.

Muscles in the Hand and Fingers

In order to fully understand the motor characteristics of fingers, it is necessary to learn the origin of the motion. To start off, the most complex structure of the five fingers which is the thumb is controlled by the thenar muscles. The thenar muscles are a group of intrinsic muscles that are found within the compartment of the thenar, slightly distinguished from other muscles because it is separated by a wall called the fascia. There are four different types of specific muscles under the specification of the thenar group, without going to the more technical aspects, one of the four types is the Flexor Pollicis Brevis, and this is the basic muscle that gives the thumb its ability to simply flex in its usual position, the fully straight stretch of the thumb. Second, Opponens Pollicis is the muscle that gives the thumb another mode of motion. This allows the abduction of the thumb. This is the movement done when you are trying to reach the pinky. The two other muscles are the Abductor Pollicis Brevis and Adductor Pollicis, these two muscles are highly different from one another, and they differ in structure mainly. The Abductor Pollicis Brevis is a sheath of muscle while the Adductor Pollicis has two heads basically, not going into more technical aspects, these muscles give the thumb its ability to abduct, the motion while grouping with other fingers or when the thumb comes close to the pointer finger. The thenar muscles can be seen just by looking at the base of the thumb, the large area and bulk generated are the muscles that mainly control the motions of the thumb.

The exact opposite of the thumb which is the pinky is controlled by another set of muscles which are called hypothenar muscles. These are intrinsic muscles that compose the medial side of the hand. They are controlled by the nerves of the deep branch of an ulnar nerve. Under the hypothenar muscles are two intrinsic muscles that give the pinky its different forms of motor motion. The first is the Abductor Digiti Minimi which origins at the pisiform and enters through the base of the pinky finger. It is mainly responsible for the abducting motion, followed by the Flexor Digiti Minimi. This muscle originates from the Hamate and comes close to the Abductor Digiti Minimi muscle. It is the key muscle that gives the pinky the flexing motion, the ability to straighten and stretch the pinky. The Opponens digiti Minimi originates also from the Hamate. What it does is that it pulls and rotates the fifth metacarpal which gives the pinky its ability to oppose the thumb or come in contact with the thumb.

If you are wondering whether the muscles controlling the three different enclose fingers are different, then you are slightly wrong. The muscles responsible for the motion of the ring, index and middle finger are all under in one classification. To start with, the Interosseous muscles which are then also later divided by seven even smaller sub-groups of muscles which are also controlled by the ulnar nerve. There are four dorsal muscles that are responsible for the flexing and three palmar muscles that are responsible for the abducting capabilities of the three fingers. The other type of muscle is the Lumbricals. There are actually four of these and are located between metacarpals. The first and second are controlled by the median nerve while the third and fourth by the ulnar nerve. These muscles give the ability of flexing and extending the three enclosed fingers. All the muscles that compose the hand are responsible for the motion of the fingers, while also the forearm is still partly responsible for some muscles that cause the movement of the fingers, like the long extrinsic muscles.

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Dupuytren Finger

Dupuytren Contracture or Morbus Dupuytren, Palmar Fibromatosis or Dupuytren’s disease is a thriving and inherited connective tissue which interferes with the straightening and bending of the fingers. A working knowledge on Dupuytren contracture symptoms and treatment is required for patients to get through the condition with less hassle.

Dupuytren Finger

Affected areas generally include the pinky and ring finger. As the condition becomes worse, it would only be matter of time before it includes the middle finger. The condition deteriorates slowly in a usually painless manner. A patient with Dupuytren finger will observe the palmar fascia thicken, then tendons thicken and the alterations in the movements of the fingers.

This condition has a greater chance of manifesting in men nearing age 40. But at the age of 80, both female and male will have a similar chance of getting Dupuytren Contracture.

The cause of the disease hasn’t been discovered yet. Recent studies revealed that these conditions could be linked to autoimmune reactions. Such reactions cause an individual’s autoimmune system to ravage its own tissues and gradually attack other parts of the body like the genitals and feet. It’s hard to figure out the symptoms since the disease develops slowly and painlessly. But some of the symptoms you can detect include the following:

Starting Symptoms

At the start of the disease, you will observe a thickening on your palm’s skin. As the disease develops, the skin over your palm will appear dimpled and wrinkled. You will observe a hard lump of tissue growing on the palm which may react to touch although generally painless.

Late Symptoms

As the disease worsens, the tissues beneath the skin will bend slowly towards the fingers and slowly tighten up. For serious cases, the fingers can be pulled towards the palms and make it hard for you to keep them straight.

In majority of cases, the pinky and ring finger are the ones that are commonly affected. It is only a rare occasion when the index finger and thumb are affected. For 45% of the cases, Dupuytren’s contracture affects both hands but one hand would appear more affected than the other. The disease affects the soles and toes only on rare occasions.

Dupuytren Finger

For severe cases, the condition may give both you and your family some problems. It will be hard for you to do the simplest tasks. It is even more difficult for you to shake someone else’s hand.

Should you observe these symptoms, it is best to seek medical support and obtain the advice of a physician so that treatment can be administered as soon as possible.

Treatment for Dupuytren’s Contracture

Treatment for the disease is administered to revive the affected hand in the best way possible. Treatment would consist of:

  • Injection
  • Surgery

Surgery is advised for contractures that limit the functionality of one’s hand. Surgery will entail the opening of the skin on affected areas and operating on the fibrous tissue. Your first surgery may not be enough and another surgery may be needed if the condition recurs.

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Trigger Finger Surgery

If you are likely to put severe stress on your hands on a daily basis then you might be prone to a condition which is called trigger finger. Basically, trigger finger is a condition that affects the fingers, specifically, the tendons that connect the fingers to the muscles of the hands. And individual with this condition is likely to experience some pain when moving the finger, this may happen in any five fingers. It will first cause numbness, swollenness and pain on the affected finger, as the condition is left untreated and continues to develop, there will be instances that the finger will be locked in a bent position. The affected individual may have difficulty in straightening the affected finger. In early stages, the lock will not last long and will be of a few seconds or moments, but if still continuously left untreated and the affected individual continues to perform severe activities that may cause stress and trauma to the hand and fingers, the individual will soon experience longer cases of locking. Furthermore, the finger may impose severe amount of pain upon movement.

The reason behind trigger finger lies beneath the tendons itself, our fingers our basically muscle-less meaning it depends on other muscles for its motor motions. The muscles that can be found in the hands and also in the forearms are mainly responsible for its motion, these are connected to the fingers with the structure called tendons, these are the string muscle like structure that are mainly responsible for the flexing and stretching of the fingers themselves. In short, the motion of the fingers are very dependent on the tendons, when the tendons are damaged, the finger’s movements are either eliminated or affected. In the event of a trigger finger, it mainly affects the tendons. The structures of the tendons include the tendons itself, covered by thin protective sheath and along the sheath, are lined with a structure called tenosynovium. The tenosynovium is a main structure of the tendon that is the key responsible in producing a lubricant that enables the smooth gliding of the tendon and the sheath itself. When the tenosynovium is inflamed, its capabilities to produce the lubricant is lessened or depleted, in this case, the lack of lubricant between the tendon and the sheath tend to result to a hard movement resulting in the lock of the finger during a trigger finger condition.

Trigger finger is a very treatable condition that can be cured in a number of ways. In earlier cases, this can be still treated through a non-surgical manner. Stopping all stressful activities that may affect the hands to give the inflammation some time to heal and recover. This can also be facilitated by a non-steroid anti-inflammatory drug like ibuprofen. Other than that, the use of a finger orthosis can be used in more developed cases, this will help stop the movement of the finger. The duration of how long the brace can be worn is usually prescribed by a doctor, depending on the severity of the condition. For some more developed cases, the use of stronger anti-inflammatory drugs like corticosteroid injections, which are steroid based shots, are used when the inflammation are already too severe. But in the cases of prolonged locks and pain during minor movements, trigger finger surgery is recommended.

The surgery mainly concentrates on removing the sheath that is constricting the movement of the tendon. There are two types, an open surgery release and a percutaneous release. By far, an open surgery is the most effective between the two but is more prone to complications and leaves a large scar. Basically, the process includes the application of an anesthetic on the affected finger, an open wound will then be done and removing the sheath. A percutaneous release, on the other hand, will no longer require the process of incision. It will require the use of a single needle that will be inserted on the affected area. This needle will then be used to separate the ligament that is constricting the tendon. This process takes place with the use of micro punctures. There would be no large scars left but is a very dangerous process. Neighboring the tendons are nerves that may be affected or damaged when not accurately performed

Trigger Finger Surgery

The treatment of a trigger finger does not end with the surgery itself. There are still precautions and a recovery process. The wound from the surgery will heal in a few days with a maximum of a week. Full movement will be back after a two-week period. Sports may be allowable after the first two weeks, but manual labor or more stressful sports like baseball, it is necessary to wait for a three week period. Patients who have undergone more than one simultaneous finger release surgery are more likely to have a longer healing period. In cases that the hands have been in severe conditions that led to stiffening of the fingers before the surgery, it is recommended that physical therapy may be applied to be able to improve the range of movement. Physiotherapy includes massage and minor finger movements, and occupational therapy, having a therapist to support you every day work to slowly help the hands development.

Surgery is not all of a safe procedure. There may be complications that would result. Minor complications like infection, pain and swelling that will heal over time. But there are cases that result in nerve damage causing lack of sensation in certain areas and are permanent effects. Tendons are placed in wrong positions also called as tendon bowstringing. Other than that, there is a small chance that the surgery is not at all effective, in an estimated of 3 percent of the cases, the trigger finger comes back.

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Treatment for Trigger Finger

As contrary to popular belief, the fingers are one of the most unique type of biological body structure because unlike other structures, the hands are the most developed, being able to perform any type of motor movement. What’s rather more bizarre is the unknown fact that fingers do not actually contain muscles. They are the only boned moving body structure that does not contain muscles, other than being unique, this fact makes our fingers also fragile. Because of the reason that fingers do not have muscles, their motor movement solely relies on the muscles that can be found in the hands and two long muscles that stretch to the forehand. The concept of motion within our hands is as simple as a puppet show. The bones in the fingers are connected to the muscles of the hands and wrist through string-like structures that are mainly responsible for the motion of the fingers. This is called tendons. Tendons are thin string like structures that are the ones that pull and give the fingers its motor motions, allowing the fingers to flex, stretch and move. They are the strings of a puppet, but like any puppet show, anything that happens with the strings, the puppets will no longer move. The same in fingers when the tendons are damaged, the finger’s capabilities is be either minimized or eliminated.

Treatment for Trigger Finger

A type of inflammation of the tendons in the hands is called trigger finger. Basically, trigger finger is named after the motion done when using a gun. In trigger finger, any finger affected may be locked in a bent position and after some time or struggle will directly pop back in a straight position. This condition affects the tendons in the fingers, what basically happens is that, tendons are thin strands of muscle like properties, the tendons are covered with a sheath like structure and in this sheath like structure is also lined again with another structure called the tenosynovium. This is the one responsible for producing a lubricant which allows tendons and the surrounding sheath to slide smoothly. In the case of trigger finger, the tenosynovium is enflamed causing the lack of production of lubricant, resulting in the inability of the tendons to simply slide through the sheath.

There are a number of reasons that causes trigger finger, namely strenuous activities using the hands may cause the tendons to be damaged or severely over used. Manual labor, baseball and many other forms that may cause regular trauma in the hands are considered some of the reasons. Also aging is a proven cause, as the human body ages, the muscles start to degrade, same as in the tendons, the tenosynovium produces less and less lubricant as an individual gets older. It is even said to occur mostly between the ages of 40 to 60 years and are most frequent in women compared to men. Diabetes, gout and arthritis are also seen as developmental causes of trigger finger. When an individual starts to feel the symptoms like a clicking or snapping sensation when the finger is bent, or pain and numbness on the joints of the fingers, it is likely necessary to seek treatment for trigger finger before the condition gets any worse.

There are a number of treatments used to control or cure trigger finger. Abstinence is a seen way to slowly recover from the injury, stopping all activities that may cause trauma to the hands, like strong gripping. This will help the inflammation to gradually heal and let the tendons recover. Some people who are not required to take surgery take non-steroidal anti-inflammatory drugs. Splinting is a method which is acclaimed to be effective for over 70 percent who have undergone the treatment. This will require the use of splint or a finger orthosis which is a type of brace that will be placed on the finger. This will prevent the finger to perform any type of motion, reducing the inflammation. The amount of time that an individual may be required to wear an orthosis depends on the doctor’s prescription which is also based on the severity of the condition. In even severe conditions, the need of corticosteroid injections may be necessary. This is an anti-inflammatory drug that will be injected to the tendons. Side effects may include slight elevation in the glucose levels of an individual. This might not be that severe but may be damaging to some diabetic patients, slight discoloration of the skin and twitching of the fingers.

The famous type of treatment known are the surgeries, there are basically two types. All of which concentrate in the idea of removing the thickened ligament or separating the sheath and tendon. The open surgery is considered as the most effective, though it is more prone to complications. Anesthetics is applied and an incision is made to remove a thickened ligament that limits the movement of the fingers, also in other terms, the removing the sheath that is constricting the tendon. The end result usually of an open surgery is a large scar. The percutaneous release surgery may not lead to a large scar and is less likely to have any complications, the process includes the use of a needle which will be used to pierce through the skin and separate the ligament through a micro incision. This process though is very dangerous. It may damage neighboring nerves close to the tendon.

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