stuck tendon?

[lacyndarella]

Jimmie holds his pinky on his left hand bent to his hand. He does this pretty much all the time. He can straighten it, but doesn't. I have straightened it, and it is very stiff and cracks when straightened out. So I asked PT about it. Diane looked at it and told me to ask OT about it. He had his OT appointment today, and Jean checked it and said it felt like a stuck tendon...I don't know, she talked about lubricants surrounding tendons and making them work...and how it is common. She said the only way to fix it is surgery. So what do you think. Basically, I'm concerned that he doesn't make full use of his hand. Who do I talk to about it? Is it worth pursuing?

[Denae]

Are they certain it isn't neurological?

Riley did this with her fist- and still does when she is having lots of partial seizures. Her thumb is tucked into her hand and it fists, you can open it but it goes right back. It is on the same side that is most effected by her seizures.

it is an old picture, but you can see her hand in the fist.
http://i50.photobucket.com/albums/f305/Denae1977/island81807.jpg

I would start with the neurologist, if he doesn't feel like it is a neurological thing then an orthopedic surgeon. I am with you, if it is hindering his ability to use his hands fully it is worth looking further into.

Sooner is better than later, did the OT mention splints, you may be able to avoid surgery with them.

[lacyndarella]

I had rather thought it was neurological, mainly because of posturing I've read about...but it really isn't his weaker side. He steps much better with is left than his right...and the pinky is bent on the left. Also, it doesn't improve with improved seizure control. He has only had one atonic seizure today...no myoclonics, no tonics (knock on wood). Pinky still bent. And it actually cracks when you straighten it. Which would make me think it is not posturing and something orthopedic.

[MikesMom]

Hi Lacy: Definitely get it looked at. It almost doesn't matter whether it's neuro or ortho in origin, if he holds it bent all the time he could eventually end up with a contracture which is not fixable. At the very least having your pinky finger curled in all the time will affect his grasp when he needs the palm of his hand and all of his fingers. Mike has all of the above. He can grasp with his right hand, but his fingers want to curl into the palm. Getting him to use all fingers and the palm now is pretty much impossible. His left hand is pretty involved in the cp and he has developed contractures in the fingers, the wrist, and the elbow. Definitely, IMHO worth following up.
Jeanette

[Tigger 76]

Splinting may help with his problem. Although I am not sure if he would wear it. I did not like to wear my split when I was his age:) Just aa thought .

[Raglet]

Just in my experience, cortical ******* (when the hand rolls up) involves the whole hand, and not just a pinky. Cortical ******* is definitely neurological. I have cortical ******* on both hands, although I can stretch them out but need splints to keep them in a 'useable' position (especially my thumbs which disappear under the palm of my hand).

Given that it is only one finger, I would rather suspect that it is a local problem (tendon or other) rather than a neurological one, but heck I'm no doctor so what would I know.

The main thing is to keep the full range of motion and stopping contractures, which either can be wearing splints (and how the heck do you get a two year to do that!) or the surgery that has already been mentioned. Tendon problem definitely can cause contractures, but generally later in life than your wee chap. In a way tendon makes sense, because the nerves in the pinky and ring finger work together and anything that is activating the nerves to curl up the pinky would be affecting the ring finger as well (just thinking aloud here, I could be way off base). But if it was tendon, then the ring finger would still be able to function properly.

Sounds like you need to have this fully investigated, as I am sure you will. Full function of the hand (well, as full as possible anyway) is very important.

btw, you have a very beautiful boy

raglet

cns lupus, mum to a beautiful autistic daughter.

[Naominjw]

This caught my eye because of my pinkie... My pinkie hurt constantly. I didn't want to use it because it hurt to do anything with it. Since I had carpal tunnel surgey, and it started hurting right after, the doctor and I thought maybe a nerve was imbedded in scar tissue. Did an MRI and saw nothing. Got a shot of cortisone twice.

Then, I happened to tell an osteopathic doctor about it and he pressed an area around the outer side of my ELBOW where some tendon connects... the pain in my pinkie went away. He showed me what to do and over the next few years when the pain would come back I did some sessions of pressing on the tendon next to my elbow.

Weird.