Thumb flexor tendon tenosynovitis

- May 29, 2020-

Thumb flexor tendon tenosynovitis

 

Thumb flexor tendon tenosynovitis refers to a condition in which the flexor tendon sheath of the thumb shows aseptic inflammation due to various reasons, causing edema and thickening of the tendon sheath, causing local pain and hindering flexor tendon extension and flexion. Mostly due to long-term repeated flexion of the thumb and straining, partly due to poor recovery of the tendon sheath after acute injury. The symptoms are mostly pain and swelling on the palm side of the thumb and palm joint, and there is a sense of bounce when the thumb is stretched and flexed. When involved, the tendon sheath was locally swollen, tender, and restricted in activity. Generally based on clinical diagnosis, it can also be combined with B-ultrasound or MRI to rule out tendon injury. B-ultrasound: Visible swelling and thickening of the tendon sheath. Nuclear magnetic resonance: swelling and thickening of the tendon sheath can be seen, and in severe cases, fluid accumulation in the tendon sheath can be seen.

 

Treatment:

1. The affected finger rests and the brace is fixed to avoid activities.

2. Oral or external use of non-steroidal anti-inflammatory analgesics and Chinese medicine, patent medicine, external washing drugs to promote blood circulation and stasis.

3. Local warmth and hyperthermia to avoid cold stimulation.

4. Soft tissue surgical treatment:

A. Local blockade

B. Small needle knife treatment

C. operation treatment

 

About small needle knife treatment:

Traditionally, small needle knife treatment is a method of traditional Chinese medicine conservative treatment. In the treatment of tenosynovitis, because it has the characteristics of percutaneous incision and release, it can also be classified as closed surgery. During the treatment, the needle knife is used to loosen the tendon sheath. Because of the percutaneous operation, the doctor cannot see the flexor tendon, which may cause damage to the flexor tendon. After treatment, the thumb wearing brace "thumb tendon sheath wrist brace" is fixed for 3 to 4 weeks to ensure the healing of the tendon injury without sequelae. At the same time, it also helps to restore the tendon sheath in a physiological position and prevent the recurrence of tenosynovitis.

The small needle knife treatment of thumb flexor tendon tenosynovitis has a low recurrence rate, but patients should understand the cause of the disease. Just like having a cold, it doesn't mean that you won't have a cold in the future. You still need to pay attention to adding or removing clothes. After the tenosynovitis is cured, long-term repeated finger strain should be avoided to reduce the pathogenic factors and prevent the disease from recurring or recurring.

Patients with diabetes and high blood pressure are not well controlled (fasting blood glucose> 10 mmol / L or blood pressure> 160/100 mmHg), and patients with severe coronary heart disease and renal failure are not recommended for small needle therapy. It is recommended that female patients during menstruation should be treated after the end of menstruation. It is recommended that fasting patients should be treated with needle knife after eating for half an hour to avoid halo needles.