[Abstract] OBJECTIVE: To summarize the clinical efficacy of acupuncture with manipulation in the treatment of adult flexor tendon stenosis tenosynovitis. METHODS: In 168 cases of 178 fingers of adult flexor tendon stenosing tenosynovitis, needle knife was applied to release the stenosing tendon, and at the same time, retraction technique was applied to expand the release area, and it was observed that there was no obstruction of finger movement. RESULTS: 168 cases of 178 fingers were cured by this method, with no pinhole infection and no recurrence. CONCLUSION: The treatment of adult flexor tendon stenosis tenosynovitis by needle knife with manipulation has the characteristics of small injury, simple operation and one-time cure, which is worth promoting and applying in orthopedic injury clinics. From June 1990 to June 2007, 326 cases of adult flexor tendon stenosing tenosynovitis were treated with acupuncture, of which 168 cases and 178 fingers were treated with acupuncture with manipulation and obtained more than 6 months of follow-up, with satisfactory results, which are reported below. 1, clinical data 1.1 General data: In this group of 168 cases, 42 cases were male, 126 cases were female, the ratio of male to female was 1:3; age 28-76 years old, average 54.4 years old; single finger onset 158 cases, two fingers at the same time 10 cases; thumb disease 116 fingers, index finger 10 fingers, middle finger 38 cases, ring finger 12 fingers, little finger 2 fingers; the shortest follow-up time of 6 months, the longest 26 months. The average was 10 months. 1.2 Diagnostic criteria The diagnostic criteria of tenosynovitis were adopted from the “Diagnosis and Treatment Routine of Common Diseases in Chinese Medicine in Beijing” [1]. Stiffness of finger movement in the morning accounted for 100% in 168 cases, snapping sound of finger extension accounted for 100% in 168 cases, local tendon sheath pressure pain accounted for 100% in 168 cases, difficulty in straightening finger flexion accounted for 86.9% in 146 cases, and pressure pain nodes accounted for 80.9% in 136 cases. 1.3 Treatment method After local disinfection with iodine and alcohol, sterile hole towel was laid, and after local anesthesia with 1% lidocaine 2 ml, the skin was penetrated vertically at the midpoint of the palmar side of the metacarpal head of the affected finger with a 1 mm diameter flat spatula-type needle knife, and an “ellipsis-like” puncture was made proximally from the distal edge of the metacarpal tendon membrane sliding carriage, about 0.8 cm in length; then the tendon sheath was cut along the 1st Each cut point should be connected to each other as much as possible, and the blade must be perpendicular to the palmar tendon slider and the fibers of the first circumflex ligament of the tendon sheath, and parallel to the fibers of the flexor tendon when cutting. The tip of the needle blade touches the palmar tendon membrane glide and tendon sheath annular ligament fibers when there is obvious resistance, cut off a sense of breakthrough, cut off a needle knife back to the surface of the palmar tendon membrane glide and tendon sheath annular ligament and then cut the second, so repeatedly until the palmar tendon membrane glide and tendon sheath annular ligament all cut, the needle knife will be withdrawn; the operator’s left hand holds the affected palm, with a sterile gauze to press the needle eye, the right hand holds the affected finger to make it straight. At the same time, the patient is asked to flex the affected finger against each other, repeatedly for 3~5 times, the palmar tendon membrane slide and the first annular ligament of the tendon sheath can be completely cut and loosened or partially cut and extended, so that the narrow tendon sheath is completely loosened. After the operation, check that the affected finger can move freely and there is no local popping and sliding feeling, then the successful release can be determined. 2. The postoperative needle eye was covered with sterile gauze, and the patient was encouraged to resume normal activities of the affected finger from the second day to avoid recurrence of adhesions. 3. Results 3.1 Efficacy criteria: According to the “Diagnostic Efficacy Criteria for Chinese Medicine” [2] prepared by the State Administration of Traditional Chinese Medicine, the evaluation criteria were as follows: cured, no pain on the palmar side of the affected finger, no local pressure pain, normal activities of finger flexion and extension, no popping and interlocking; improved: local swelling and pain were reduced, slight pain when the affected finger moved, or mild popping, but no interlocking; not cured: clinical symptoms No improvement. The efficacy assessment was based on 3 weeks as the recent efficacy and 6 months as the long-term efficacy. 3.2 Follow-up results: 168 cases of 178 fingers in this group were treated by acupuncture with manipulation for one time, and the local ringing disappeared at that time after treatment, without complications. 4, discussion 4.1 site and cause adult flexor tendon stenosis tenosynovitis stenosis site are in the metacarpophalangeal joint palmar tendon membrane slide (PA) and the first annular ligament (A1), this is the tendon and tendon sheath friction stress site, repeated strain stimulation tendon sheath synovial inflammatory reaction, tendon sheath tissue hyperplasia and cause tendon sheath stenosis, coupled with the palmar tendon membrane slide (PA) and the first annular ligament (A1) The flexor tendon between the palmar tendon sheath (PA) and the first annular ligament (A1) is enlarged due to the absence of the tendon sheath on the palmar side, which increases the resistance of the tendon to slide in the tendon sheath and further aggravates the inflammatory reaction, forming a vicious circle, and when the stenosis develops to a certain degree, strangulation can occur and aggravate the dysfunction of finger flexion and extension. 4.2 Characteristics of this method The application of acupuncture treatment for flexor tendon stenosis tendinitis has good efficacy, but simple acupuncture release sometimes cannot achieve a single release. In this method, on the basis of the needle knife release, together with the manual release, the palmar tendon membrane slide and the first annular ligament of the tendon sheath can be completely cut and released or partially cut and extended, so that the narrow tendon sheath can be completely released.