Minimally invasive approach to stenosing tenosynovitis

  Tenosynovitis, also known as “popping finger” or “trigger finger”, is a very common clinical condition of chronic soft tissue injury of the hand. The tendon is the part that connects the muscle to the bone or other muscles, while the tendon sheath is the sheath-like structure that surrounds the tendon and holds the tendon to the periosteum to prevent the tendon from popping up or sliding to the sides. In a normal state, when the tendon sheath is free to slide, there is neither pain nor other unusual symptoms. Once sterile inflammation of the tendon sheath occurs, the tendon sheath becomes swollen, limiting free gliding and strangling the tendon, causing painful symptoms. If the inflammation is prolonged and the tendon is squeezed for a long time, a small dumbbell-shaped structure with swollen ends and a thin middle will appear, which will cause the tendon sheath to move back and forth, resulting in a “stuck” phenomenon and even a “thumping” sound.  Tenosynovitis can occur in any finger, most often in the thumb, index and middle fingers, and in a few patients, multiple fingers can develop at the same time. In general, most people with tendinitis work with their hands, including computer operators, carpenters, packers, weavers, and accountants. Middle-aged women tend to develop it because they often do household chores, such as rolling noodles and washing clothes.   If there are no symptoms of ‘thump, thump, thump, thump’ and simply painful early tendinitis, some patients are able to stop at this step and not continue down the road through conservative treatment. Patients with ingrown finger flexor tendons or typical ‘trigger finger’ signs when moving the finger need to be treated surgically. At present, most of them are treated by surgical excision of the local lesion of the tendon sheath of the finger flexor tendon and release of the tendon. However, the traditional surgical treatment method requires an incision of about 1.5 cm at the affected area, which results in more bleeding, more damage, and longer recovery time, requiring 14 days to remove the stitches. During this period, the incision cannot be exposed to water, which brings a lot of inconvenience to life and work. In addition, there are problems such as scar adhesions of the surgical incision.   Based on the local anatomical characteristics of the finger flexor tendon and in-depth research on its pathogenesis, I designed and developed the “syringe needle cutting treatment for stenosing tenosynovitis” on my own. There are several features, one is that the technique is minimally invasive, the eye of the needle is very small, only 0.2 cm, bleeding is minimal, basically not out. Secondly, no sutures are needed after surgery, only a piece of gauze or one or two band-aids are needed. Third, the healing time is fast, if there are no other diseases, the wound can be healed in 2 days, you can get wet, and the impact on life and work is small. The fourth is the low cost of surgery, if you take Western medicine tendinitis surgery, in addition to hospitalization costs, only the cost of surgery at least 500 yuan or more, while my minimally invasive surgery only needs more than 100 yuan. Three is the western tendinitis surgery patients need to be hospitalized, the surgery time is long; and by the hospital’s original tendinitis surgery patients do not need to be hospitalized, in the outpatient operating room can do, just a few dozen seconds, can solve the tendinitis problem, to achieve immediate results. The first thing you need to do is to get a good idea of what you’re looking for.  As the saying goes, “three parts of treatment and seven parts of maintenance”. Postoperative rehabilitation and wound care for the affected finger is also important. Patients should do full flexion and extension training of the affected finger joint, 300-500 exercises per day for 3 days to prevent postoperative tendon adhesions.