Tenosynovitis.
Tendon stenosing tenosynovitis is a painful and impaired movement caused by long-term inflammation of the outer envelope of the tendon and localized narrowing of the canal. The relationship between the tendon and the tendon sheath is like the relationship between the metal wire and the outer skin plastic in an electrical wire. The main problem is that if the tendon is rubbed excessively for a long period of time and strained locally, an inflammatory injury to the tendon and tendon sheath can occur, causing swelling and pain, called tenosynovitis. If left untreated, it may develop into permanent mobility problems. Stenosing tenosynovitis of the thumb often occurs in middle-aged and older women who do more manual or domestic work. Tenosynovitis of the wrist often occurs in women who lift heavy objects, especially within six months after childbirth and in women who care for infants and young children.
Clinical manifestations.
The finger often occurs in the thumb, middle and ring finger, and initially produces popping and pain when the finger is flexed and extended, so it is also called “trigger finger”. Pain usually occurs in the metacarpophalangeal joint, but most patients feel pain in the proximal phalanges as well. Nodules are usually palpable in the metacarpophalangeal joint, and there is pressure pain. Patients often report joint immobility and swelling. In severe cases, the joint is strangulated in flexion or extension and the joint cannot be straightened or flexed. The disease is occasionally seen in pediatric patients with bilateral thumbs in the flexed position and unable to actively straighten. The wrist often occurs in the radial styloid process and the ulnar carpal extensor tendon, and the pain is severe when the wrist is extended ulnarly or radially.
Treatment.
When first diagnosed or when the symptoms are mild, conservative treatment with braking, physiotherapy or local closure can be used, and the symptoms can be relieved, but it is easy to recur after exertion again. Painkillers are effective and creams are generally ineffective. Surgery can be used if the symptoms do not improve significantly with non-surgical treatment or if there are recurrent attacks. Surgical treatment is not to cut the tendon sheath around the tendon and remove a part of it, if there are tendon adhesions here, they should also be released at the same time. Surgery is more effective and recurrence is less common. Small needle treatment is also possible, but tendon and nerve injuries are common in those unfamiliar with the anatomy or in those who encounter anatomical variants. Children up to 2 years old can be observed, and if they do not recover they should be treated surgically in time.
Postoperative exercise.
More hand pressure should be applied to the surgical site for 2 hours after surgery to prevent bleeding. The extension and flexion exercises of the surgical site should be started the next day. The exercises should be performed as straight and as flexed as possible, 3-5 times a day, with 10 extensions and flexions each time to prevent adhesions.
Prevention
Pay attention to maintaining the correct posture at work, avoiding excessive strain on the joints, and taking regular breaks.
When doing laundry, cooking, knitting sweaters, cleaning and other household chores, pay attention to the correct posture of fingers and wrists, do not overbend or back stretch; do not carry too heavy items; do not exert too much force on fingers and wrists.
Continuous work time should not be too long, after the work to rub the fingers and wrists, and then hot water to soak hands.
In winter, it is best to use warm water when washing clothes, snow after sweeping snow should also wear cotton gloves to prevent the hands from being cold.
For long-term office workers, should adopt the correct working posture, try to make the hands balanced, wrists can touch the real thing, do not hang.
Wrist joints to do a 360-degree rotation; or the palm of the hand to make a hard fist and then relax, back and forth a few more times or the fingers back pressure or palm back pressure a few times, can effectively relieve hand pain.
You can take a hot bath when you feel fatigued in your body joints to relieve the tight muscles, or apply heat to the sore areas. Tendonitis can be easily caused by frequent computer use.
Schematic diagram of the onset and incision design
Intraoperative incision for tendon sheath release
Postoperative incision about 1.4cm