Thumb tendon sheathitis

　　It can be caused by injury, excessive fatigue (especially seen in hands and fingers), osteoarthritis, some immune diseases, or even infection. Some professions that require long-term repetitive fatigue of joints, such as typists, instrumental musicians, cargo handlers, or industries that require long-term computer operations, may trigger or worsen this disease. Common affected areas include the wrist, fingers, shoulders, etc. Women and diabetic patients are more prone to this disease. Patients may feel joint pain, stiffness in the morning, which is most obvious after waking up, and the symptoms will not be significantly alleviated with frequent activity. The affected joints may swell, even with a popping sound, and joint movement disorders.

　　Necrotizing tenosynovitis is caused by tuberculosis bacteria.

　　Firstly invades the synovium of the sheath, extending from the palm along the ulnar and radial sides of the bursal sac through the carpal tunnel to the forearm. The sheath thickens due to infiltration of tuberculous granulation tissue, containing yellow exudate and yellow rice grain bodies. Gradually, the tendons are also infiltrated by granulation tissue, forming nodular hypertrophy and losing the original smooth motility. When the granulation tissue invades other tenosynovia and nerves, it can cause flexion and sensory disorders.

　　Carpal tunnel syndrome of the flexor tendon sheath is most common between the thumb and the middle finger. The flexion and extension function of the affected finger is impaired, especially obvious when waking up in the morning, which can be alleviated or disappear after activity. The pain sometimes radiates to the wrist. The metacarpophalangeal joint flexion can be painful, and sometimes it can be touched that the tenosynovium is thickened, like a pea-sized node. When bending the affected finger, it suddenly stops at a semi-bent position, the finger cannot be straightened or flexed, as if it is suddenly 'stuck', the pain is difficult to bear. With the help of the other hand, the finger can be moved again, producing a trigger-like action and sound, hence also known as 'trigger finger'.

　　Wrist rotation is one of the simplest preventive exercises. When the sharp pain begins, some gentle hand movements can be done to relieve the pain. Rotate the wrist for about 2 minutes. All the wrist muscles can be exercised, restore blood circulation, and eliminate the bent wrist posture, which often causes wrist pain and other symptoms.

　　The most common clinical examination method for thumb tendon sheathitis is: general radiography.

　　1. Local swelling: See the early symptoms of tenosynovitis above.

　　2. Local tenderness: The tenderness around the injured part of the sheath and its surroundings is obvious.

　　(1)Ginger chicken: Use 1 rooster that has just begun to crow, 100~250g of ginger, cut into small pieces, fried and stewed in a pot without adding oil or salt. It is suitable for drinking.

　　A drinker can consume a small amount of alcohol, finishing it within 1 day, and can eat once every 1 week or half a month. It is used for joint cold pain, those who prefer warmth and fear cold.

　　(2)Deer Antler Chicken：Use 1 male chicken of the year, 3-6g of deer antler, stew in a pot without oil or salt. Eat the meat and drink the soup, finish in two days. Eat according to the situation once every 1 week or half a month. Do not use in summer or in cases of joint redness and pain.

　　(3)Red Bean Porridge：30g of red bean, 15g of white rice, and an appropriate amount of sugar. First, cook the red beans until they are done, then add white rice to make porridge and add sugar, which can remove dampness and heat.

　　(4)Coix Seed Porridge：30g of Coix Seed, a little starch, sugar, and适量 of osmanthus. First, cook the Coix Seed, when the rice is cooked, add a little starch, then add sugar and osmanthus. It can be used as breakfast, which can clear dampness and heat, and strengthen the spleen and relieve stiffness.

　　(5)Fangfeng Coix Seed Porridge：10g of Fangfeng, 30g of Coix Seed. Boil in water, once a day, take for one week, can clear heat and relieve stiffness.

　　(6) 25 grams of Eucommia ulmoides, 30 grams of Dipsacus asper, and 1 pig tail, boil and season to eat.

　　(7) 15 grams of Mulberry Seed and 1 egg, boil and take.

　　(8) 6 grams of old mulberry branch, with a 500-gram female chicken, boil and drink the soup.

　　(9)Sesame Seed Porridge：Sesame seeds 15 pieces, pork kidney 1 pair, glutinous rice 30 grams. First, fry the chestnuts (using sand to fry), then remove the shell, and cook with glutinous rice and an appropriate amount of water. Or dry the chestnuts in the wind, grind them into powder, and cook with chestnut powder 30 grams, glutinous rice 20 grams, pork kidney 1 pair, and make porridge as well, 1 small bowl each time, once a day. This recipe has the effect of kidney and muscle strengthening, spleen and stomach nourishing, and can be used for the syndrome of sciatica due to kidney and spleen deficiency.

　　The common treatment methods for thumb tenosynovitis mainly focus on the following two aspects:

　　Closed Treatment

　　It can alleviate early tenosynovitis, and the treatment is closed once a week. Generally, the closed treatment method is more harmful to local tissues and prone to recurrence. Severe patients can choose surgical treatment, and early finger flexion and extension activities should be performed after surgery to prevent tenosynovitis adhesion. Avoid manual labor for one month after surgery.

　　Surgical Treatment

　　After surgery, suitable splints should be used for fixation. In cases where non-surgical treatment is ineffective, small needle knife decompression or tenolysis can be performed. Make an incision at the palmar transverse crease, separate with forceps directly to the tenosynovium, and avoid injury to the finger vascular nerve bundle.