When a tendon crosses a joint with a large angle of rotation or slippage, a tough tendon sheath restrains it to the periosteum to prevent the tendon from springing up like a bowstring or slipping to the sides. Thus, the tendon sheath and the bone form a “bone and fiber tunnel” with very little elasticity. The proximal or distal edge of the tendon sheath is a stiffer rim, and the thickening of the tendon sheath is most pronounced at the metacarpophalangeal joint, called the circumferential ligament. Tendon stubble this ligament edge long-term, excessive force friction, can occur after the tendon and tendon sheath injury inflammation. However, because the tendon sheath is tough and inelastic, as if the tendon sheath is hyperplastic and edematous, the tendon sheath is stuck in the tendon, so it is called tenosynovitis, or stenosing tenosynovitis. The tendons of the extremities that pass through the “bone a fibre attempt”, can occur tenosynovitis, such as biceps long head tenosynovitis, thumb long extensor and total extensor tenosynovitis, peroneal long and short muscle tenosynovitis, finger flexor tendon tenosynovitis, thumb long flexor tenosynovitis, thumb long extensor and thumb short extensor tenosynovitis, etc.. The last three are the most common, so they are described below as representatives. Stenosing tenosynovitis of the hand and wrist is the most common type of tenosynovitis and is most common in middle-aged and elderly women, light industrial workers and orchestral musicians who use their fingers and wrists rapidly and forcefully for long periods of time. In the fingers, flexor tenosynovitis occurs, also known as popping finger or trigger finger; in the thumb, thumb flexor tenosynovitis, also known as popping thumb; in the wrist, thumb extensor tenosynovitis and thumb extensor tenosynovitis, also known as radial stenosis tenosynovitis, or deQuervain’s disease. The cause of the disease is long-term rapid finger activity, such as knitting sweaters, orchestral music practice or performance; long-term forceful finger activity, such as laundry, writing manuscripts, typewriters, computer operation and other chronic strain injury is the main cause. If the patient has congenital tendon abnormalities (pediatric thumb flexor tenosynovitis), rheumatoid arthritis, postpartum, and post-illness weakness, the disease is more likely to occur. Pathologic stenosing tenosynovitis is not a purely injurious inflammation of the tendon sheath; both tendon and tendon sheath have edema, hyperplasia, adhesions, and degeneration. The edema and hyperplasia of the tendon sheath narrow the “bone and fiber tunnel”, which in turn compresses the already edematous tendon, and the tendon sheath cavity is particularly narrow and tough in the annular ligament area, so the edematous tendon is compressed into a gourd shape, preventing the tendon from sliding. If the finger is stretched and flexed with force, the gourd-like enlarged part is forced to squeeze through at the annular ligament, producing popping action and ringing sound, accompanied by pain, so called popping finger. A, clinical manifestations 1, popping Zu Zu finger and popping thumb slow onset: Initially, the morning finger stiffness, pain, slow activity that disappears. With the lengthening of the disease gradually appear popping with obvious pain, severe cases of the affected finger flexion, afraid to move. The frequency of onset of each finger is most frequent in the middle and ring fingers, followed by the thumb and little finger. Patients often report pain in the proximal interphalangeal joint, but not in the metacarpophalangeal joint. On physical examination, a painful nodule the size of a soybean can be found in the distal transverse palm stripe. The nodule moves up and down with the flexor tendon when flexing and extending the affected finger, or it may appear to be plucked, and it is felt that the plucking occurs here. Painful nodules may be found subcutaneously in the metacarpophalangeal joint. The pain in the radial side of the wrist joint is gradually aggravated, and there is no ability to lift things. There are no signs of skin inflammation on examination. There is limited pressure pain on the surface of the radial tuberosity or its distal side, and sometimes painful nodules can be found. The pain at the radial styloid process is called positive Finkelstein test when the ulnar carpal joint is clenched. Treatment 1. Local braking and intra-tendon sheath injection of prednisolone acetate or Depo-Provera has good efficacy. But the injection must be accurate, injected under the branch is ineffective, once injected into the radial artery superficial branch, there are three hands on the radial side vasospasm or embolism leading to finger end necrosis may. 2, if non-surgical treatment is ineffective, consider performing a narrow tenosynovectomy: local anesthesia, make a small incision at the painful nodule. After cutting the skin, bluntly detach the skin, pay attention to the dermal nerve and blood vessels on both sides, and fully expose the tendon sheath. At this point, the patient’s fingers are moved passively and the enlarged nodule can be seen moving up and down the tendon sheath stenosis. The thickened tendon sheath is identified, and the tendon sheath is incised from one side with a small sharp knife, and then the sides and anterior wall of the narrowed tendon sheath are cut with small scissors in order to completely release the stenosis. If only the stenosis is incised, sometimes re-adhesion occurs and the symptoms recur.