Flexor tendon stenosis tenosynovitis: also known as “popping finger”, “trigger finger”, is a common clinical disease, multi-infarcts, most common in the thumb, the middle finger and ring finger second, there are a few patients with multiple fingers at the same time, to middle-aged women are more common, when the finger frequent activities, so that The flexor tendon and the bony fiber canal are pressurized, the fiber canal itself becomes edematous and thickened, followed by fiber canal degeneration, narrowing the canal lumen, the flexor tendon becomes thin due to pressure, but the two ends of the base are expanded in a gourd shape, when the finger flexes and extends, it can barely pass and emits a popping sound. The incidence of congenital trigger finger of the thumb is high in children, accounting for almost 25% of newborns, and bilateral trigger finger of the thumb occurs from time to time. Because the interphalangeal joint of the thumb is often in a flexed position during the neonatal period, the child is uncooperative in the examination, and although the diagnosis is easy, it is often missed due to lack of awareness, which affects the development and function of the affected finger. This disease belongs to the category of “paralysis”. It is mostly due to strain, wind, cold and dampness, paralysis and obstruction, and pain if it does not pass. Our department adopts comprehensive treatment for this disease. The causes of flexor tendon stenosis tendovaginitis: (1) chronic strain: long-term repeated excessive flexion and extension activities of the metacarpophalangeal joint, so that the deep and shallow flexor tendons rub against each other, or long-term hand-held tools, fiber sheath tube by hard objects and palm bone extrusion, resulting in aseptic inflammation of the tendon and tendon sheath. (2) Anatomical factors: the lesion is likely to occur at the beginning of the fibrous sheath canal of the flexor tendon corresponding to the head of the palm. (3) Degenerative factors: With the increase of age, the hand activity also gradually decreases, and the sudden occurrence of some repeated and frequent finger flexion and extension activities causes the local tendon sheath to be filled with blood and edema. (4) Congenital thumb trigger finger often has an obvious family history, excessive flexion of the thumb during fetal life, excessive flexion of the metacarpophalangeal joint of the thumb, and long-term compression of the flexor tendon at the entrance of the palmar tendon sheath of the metacarpophalangeal joint of the thumb are the main causes of tendon sheath thickening and tendon expansion; it is also believed that degeneration of the tendon itself may also be one of the causative factors. The pathological changes of flexor tendon stenosing tenosynovitis: repeated frequent or excessive activities, the lesion of the fiber sheath local congestion, edema, early untreated or improper treatment followed by fibrosis, sheath thickening, lumen formation of circular narrowing, and even cartilage degeneration and calcification of the sheath, the lesion of the tendon long-term pressure is gourd-shaped or pike expansion, dark yellow, loss of the original luster. Most of the patients still and increase their finger flexion and extension activities after the onset of the disease, resulting in the friction between the tendon and the tendon sheath carriage aggravates the pain and local inflammatory reaction, which further aggravates the tendon sheath stenosis, forming a vicious circle. The clinical manifestations of flexor tendon stenosis tendinitis: the affected finger is restricted in extension and flexion, mostly in the palmar side of the finger, pressure pain at the transverse finger line, palpable strips or hard knots, when the affected finger is flexed suddenly stays in a semi-flexed state, and then when the finger is flexed with force, the affected finger can feel the sudden jumping phenomenon after being blocked, accompanied by finger popping, and in some cases, it is necessary to use the healthy hand to help trigger to restore the original position. The congenital interphalangeal joint of the trigger finger is flexion deformity in children, and extension and flexion are limited. The palmar side of the metacarpophalangeal joint is palpable with tough nodules, but the pressure pain is not obvious. The passive extension and flexion of the interphalangeal joint can have a popping sound, and some cannot even passively straighten the interphalangeal joint, which is clinically manifested by reluctance to move or play with the affected hand, which is a major difference from adult stenosing tenosynovitis. Staging criteria: According to the characteristics of the patient’s condition, it is divided into three stages: (1) early stage (inflammatory stage): short duration of the disease, local pain is obvious, no obvious signs of compression such as popping; (2) middle stage (stenosis stage): longer duration of the disease, local pain is not very intense, there is obvious difficulty in extending and flexing the finger, there is popping, nodule-like objects can be examined sliding and popping sensation; (3) late stage (adhesion stage): long duration of the disease, generally no local pain, the finger is fixed in the extension position or in the extension position. The finger is fixed in the extension or flexion position, and relapses after repeated treatment. (2) Treatment of flexor tendon stenosis tendinitis: congenital trigger finger in children can heal spontaneously. Most of the children in the age of 2 to 3 years signs and symptoms disappear, but if long-term conservative treatment is not effective, it is not necessary to observe, so as not to affect the development of the thumb, it is recommended that if the disease is found at birth, the thumb can be fixed in the straight position with a splint for 6 weeks, if the symptoms are not relieved, should be treated as soon as possible, the affected finger must be loosened before the age of 3 years, if too long without timely treatment to loosen or the emergence of strangulation or popping can not be self-healing. Early treatment is necessary, otherwise the function and normal development of the thumb will be affected and the affected finger will be significantly smaller than the opposite side. Adults also need treatment. The following are some examples of treatment methods for reference: (1) The most primitive treatment method: Chinese herbal fumigation treatment: one side: Sumac, Salvia, Safflower, Boswellia, Myrrh, Qiangwu, Weilingxian, Wujiapi. Second side: safflower, mugwort, red peony, danshen, cinnamon stick, tendon grass, chicken blood vine, percocet, Qin Wu. Third formula: Radix Rehmanniae, Radix Rehmanniae, Rhizoma Polygonatum, Radix Bupleurum, Radix Bupleurum, Radix Pseudostellariae, Radix et Rhizoma Millenium, Radix Wei Lingxian, Radix Gui Zhi, Radix Gentianae, Radix Qiang Wu, Radix Dou Hua, Radix Lutong, Rhizoma Ephedra, Radix Safflower, Radix Szechuan pepper, Atractylodes Macrocephalae, Radix Angelicae Sinensis. Add water and boil for 15 min and then place the affected finger on the basin, cover with a towel for fumigation, after the temperature of the medicinal solution is reduced, put the affected finger into the solution and soak it, gently move the affected finger. 2 times/d, 30 min/time, 7 days for a course of treatment, be careful of burns. (2) The most environmentally friendly treatment method: acupuncture treatment: take the ayurvedic point, feel the pressure and painful hard nodes, then around the hard nodes respectively, add warm acupuncture, about 30 min. 3 times a week, 6 times a course of treatment. (3) The most pain-relieving treatment method: closed treatment: compound betamethasone injection, lidocaine vertical needle into the tendon sheath, back to draw no blood and then push the drug, retreat the needle to the pain-causing point around the push to finish the drug. (4) The treatment method of minimum payment: warm water immersion method: slowly put the hand into the prepared basin of hot water containing 43~46℃, the water must submerge the hand, especially the painful part, and gradually add hot water in the process of immersion to maintain the required temperature. The general soaking time is 30 minutes, 2 times / day, 10 days as a course of treatment. Dry your hands after soaking and avoid wind blowing. (5) The simplest treatment method: pressure moxibustion at the A-Yi point: find the pressure point and perform pressure moxibustion with 3 strokes of moxa cones, do not get water on the affected area for 2 hours after moxibustion. Do not put water on the affected area for 2 hours after moxibustion. Treat once a day, 5 times in total. (6) The greenest treatment method: infrared polarized light treatment: according to the condition, select 2~3 obvious pressure pain points, infrared polarized light treatment head, put it close to the pressure pain points, irradiate each point for 5 min, 1 time/d, 10~15 times for a course of treatment, usually 1~2 courses of treatment. (7) The most direct treatment method: topical application of Chinese herbal medicine: Angelica sinensis, Rhubarb, Tongpi, Hossein, Chuanwu, Cao Wu, Cumin, Dilong, Qiangwu, Dushu, Cangzhi, Fangji, Fangfeng, camphor, finely powdered. Take appropriate amount of 75% alcohol and wet with a small piece of gauze wrapped on the affected area. Wet with alcohol once a day, 3 d to take off. Can be applied daily with hot water on the affected area before external application to facilitate drug absorption. (8) The most regulating treatment: Chinese herbal medicine taken internally: Astragalus, Guiweiwei, Radix Paeoniae, Di Lung, Chuanxiong, Rhizoma Ligusticum, Peach kernel, Safflower. 1 dose daily, decoction in water, divided into 2 doses. Third, the care of flexor tendon stenosis tenosynovitis: (1) Let yourself know the causes of the condition and preventive measures. (2) Keep warm: avoid washing hands with cold water to prevent pain caused by tendon sheath spasm. (3) Avoid unaccustomed long hand and wrist activities and prolonged overexertion to prevent strain on tendons and tendon sheaths. (4) Soak in warm water and observe changes in the skin at all times to prevent burns.