Patient: Pain in the left thumb with morning stiffness, is it tendonitis?
Liu Limin, Department of Orthopedics, Beijing Xuanwu Hospital.
Hello, your symptoms can be differentiated from tendon sheath stenosis, rheumatoid arthritis, Raynaud’s syndrome, etc. Among them, tendon sheath stenosis is the most common, and can be treated symptomatically by topical medication first. Liu Limin, Department of Orthopedics, Xuanwu Hospital, Capital Medical University
We suggest you to visit the orthopedic department of your local general hospital.
Patient: Dr. Liu: Thank you for your serious reply. I once had an operation because the elbow ulnar nerve was compressed, causing muscle atrophy between the thumb and the index finger, and the elbow ulnar nerve was displaced to the side of the elbow joint, which was opened in the hand surgery department of Shanghai Huashan Hospital, and it has been 3 months now. I will go to the orthopedic hospital to see, just very interested in knowing as you are.
Liu Limin, Department of Orthopedics, Beijing Xuanwu Hospital.
Hello this patient, you mentioned that the first dorsal interosseous muscle atrophy was performed with the surgery of ulnar nerve anterior displacement, and the symptoms of ulnar nerve compression are as follows.
1, abnormal sensation on the ulnar side of the dorsum of the hand, the small fissure, the little finger and the ulnar half of the ring finger, usually numbness or tingling. 2.After the occurrence of sensory abnormalities for a certain period of time, weakness of the little finger to the palm and inflexibility of finger retraction may occur. 3.Examination may show atrophy of the interosseous and interosseous muscles of the hand, and orthopedic claw-like deformity of the ring and little fingers, hyperalgesia of the skin in the aforementioned areas, positive paper-clip test (hold a piece of paper between the two fingers of both hands, and observe whether the force of the paper-clip is the same on both sides of the patient) and positive Tinel’s sign at the ulnar nerve sulcus (tap the site of nerve alignment locally to observe whether there is pain and numbness of nerve conduction). The patient’s nerve was found to be positive. 4. Electrophysiological examination revealed that the conduction velocity of the ulnar nerve under the elbow was slowed, and the electromyogram of the interosseous muscle and the interosseous muscle was abnormal. 5.Evidence of underlying disease such as elbow valgus, thickening of the ulnar nerve sulcus with mass. x-ray shows local displaced bone mass or abnormal ossification, etc.
If your problem has appeared before the surgery, you can continue to take oral neurotrophic drugs for a period of time, otherwise, you can consider visiting orthopedic and rheumatology departments.
(I’m a little late in replying because I’m a little pressed for time recently)
Patient: Dr. Liu: I am very impressed that you are so serious in answering my questions. The symptoms you mentioned before my surgery are completely correct, maybe the current condition is normal after the surgery. Also which oral neurotropic medicine is better, I hope to get your guidance.
Liu Limin, Department of Orthopedics, Xuanwu Hospital, Beijing.
Hello, there are more neurotrophic drugs, the ones commonly used in our department are VB1 and 12, methylcobalamin tablets, one tablet three times a day. You can take them according to your doctor’s advice according to the local situation.
The so-called morning stiffness refers to the restriction of movement for more than half an hour after waking up in the morning. You can observe it for a period of time and consult your local doctor when you review it after surgery.
Your condition is understood. Suggestion: Click here to refer to my article “Awareness of Elbow Tunnel Syndrome”.