Tenosynovitis (tenosynovitis), also known as snapping finger or trigger finger. It can occur at different ages, mostly in middle-aged women and manual laborers. From August 2004 to March 2006, the author used small needle knife plus closure therapy to treat 48 cases of recalcitrant snapping finger, and achieved good results, which are reported below. General information All cases were outpatients. There were 48 cases of 48 fingers, of which 16 were male and 32 were female. Age ranged from 45 to 68 years. The thumb was 34 in 34 cases, accounting for 70% of the total index. The longest medical history was 2 years and the shortest was 3 months. There were 29 cases and 29 fingers of recurrence after improvement of previous closure treatment. Among them, 9 cases and 9 fingers received more than 2 times of closure treatment, and the rest of the patients had received more than 2 weeks of conservative treatment. The majority of the patients had more finger activities. Some patients had a history of finger injury and strain, and some had no obvious cause. All of the patients presented with unfavorable finger flexion and extension, popping, trigger finger, and pressure pain at the palmar aspect of the metacarpophalangeal joint. The patient is seated, the affected hand is placed flat on the treatment table with the heart upward, the node is marked with gentian violet, the field is routinely disinfected, the operator wears sterile gloves and covers with sterile wipes, the node or pressure pain is palpated on the palmar side of the metacarpophalangeal joint, the needle knife blade is inserted vertically parallel to the tendon, the patient is asked to actively flex and extend the finger, the operator can feel movement on the needle knife, the tendon ring at the node is incised longitudinally, the operator can feel and hear the cutting sound and There is often a small amount of synovial fluid from the eye of the needle, usually no bleeding, cut about 0.5-1cm tendon ring, so that the needle knife in the local longitudinal stripping without obstruction, and then appropriate several lines of transverse stripping, and ask the patient to perform finger flexion and extension activities, if the flexibility is free, then remove the needle knife; and then 5ml syringe to extract 0.3ml trimethoprim plus 1% lidocaine to 2ml, injected into the affected finger tendon sheath and around the tendon sheath, remove the needle, paste the infusion patch. The needle is removed and the infusion patch is applied. The operator uses one thumb to press the area, and the other hand to squeeze the affected finger to perform 2 to 3 times of passive hyperextension activities, so that the tendon sheath at the incomplete incision is held open by the tension of the tendon, and the operation takes less than 10 minutes. The treatment standard is based on the “Diagnostic and therapeutic criteria for Chinese medicine” implemented in 1995. Cured: The swelling and pain of the lateral part of the metacarpal finger disappears, the flexion and extension activities return to normal, and there is no popping sound or interlocking phenomenon. Improvement: Local swelling and pain were reduced, but there was still slight pain when moving, or there was a popping sound, but no interlocking phenomenon. No improvement: No improvement in symptoms. Treatment results Among the 48 cases in this group, 45 cases were cured by acupuncture only once, with a cure rate of 93%; 2 cases had significant improvement in finger flexion and extension activities after acupuncture treatment for one time, but some residual flexion and extension incompleteness remained, and were treated with acupuncture again in about two weeks, with complete recovery of finger flexion and extension activities after active and passive flexion and extension training, with a secondary cure rate of 97.9%; 1 case had postoperative swelling and pain and no relief of symptoms. 47 cases were followed up for 3 months to 9 months (mean 5 months), with no 1 case having any improvement in symptoms. Forty-seven cases were followed up from 3 months to 9 months (average 5 months), with no recurrence in one case. The tendon can slide normally in the sheath in order to complete the finger joint flexion and extension movement. The frequent activities of the fingers cause abrasion and strain on the tendon and tendon sheath, inflammatory swelling, thickening of the tendon and thickening of the sheath wall, resulting in tendon sheath stenosis, and the tendon sheath stenosis compresses the tendon in a gourd shape, which eventually affects the sliding of the tendon in the sheath and the finger movement. The immediate effect of local closure alone is good, with anti-inflammatory and pain-relieving effects, but there is a certain recurrence rate. 29 cases in this group were recurrent patients after closure (9 of them had received more than 2 times of closure). Surgical treatment, although the cure rate is high, but the need for anesthesia, incision and suture, relatively complex and time-consuming, while small needle knife therapy without more instruments, one person a needle knife can be, simple and easy, no hospitalization, no antibiotics, less money, no bleeding, less pain, only puncture needle eye without incision, no suture, no postoperative skin scar, and then with the closure treatment, the operation time is short, fast, high cure rate, easy to be The operation time is short, the effect is fast, the cure rate is high, and it is easily accepted by patients. It is important to be familiar with the local anatomy before operation to avoid accidental injury to blood vessels and nerves. The amplitude of stabbing the tendon sheath is not too large, and there is a certain feeling of falling when piercing the sheath, so as not to cut too deeply and injure the tendon inside the sheath. One invalid case in this group was caused by local vascular injury due to unskilled operation, and postoperative pressure was not applied in time to stop bleeding, resulting in local hematoma and adhesion, which affected the surgical effect.