Metacarpophalangeal tuberculosis

　　Metacarpophalangeal tuberculosis is caused by the blood-borne route of Mycobacterium tuberculosis. The pathological changes of骨干tuberculosis are mainly hyperplastic, with osteolytic destruction being secondary, and the formation of dead bone is relatively rare. The short bone骨干tuberculosis of the hand also mainly presents hyperplastic changes, with the formation of dead bone sometimes visible, and its pathological changes are slightly different from those of long bone骨干tuberculosis. Common changes include osteoarthrosis, that is, bone expansion and thinning, and the medullary cavity is expanded due to osteolytic destruction. The formation of dead bone is more common in short bone骨干tuberculosis than in long bone骨干tuberculosis. This may be due to the smaller size of the bone, and the opportunity for the disease to affect the joint is more than that of long bone骨干tuberculosis. The incidence of tuberculosis in the short tubular bones of the hands and feet is much higher than that in long bone骨干tuberculosis, considering that the surrounding muscles of the short tubular bones are smaller or absent, lacking the protective effect of muscles. In addition, the nutrient vessels of the short tubular bones are thinner, the blood flow is slow, and bacterial emboli are more likely to stay locally and cause disease. In hand metacarpophalangeal tuberculosis, the number of cases of metacarpal bones is higher than that of phalanges, and the distal phalanges are rarely seen. Among the five fingers, the metacarpal and phalangeal bones of the first, second, and third fingers have a higher incidence rate, while the metacarpal and phalangeal bones of the fourth and fifth fingers have a lower incidence rate.

　　After the skin abscess of metacarpophalangeal tuberculosis ruptures, sinus formation may occur. The main cause of sinus formation is the invasion of bacteria into bone and soft tissue, causing a form of local persistent chronic inflammation where bone and soft tissue almost simultaneously appear. These bacteria or the various inflammatory mediators they cause continuously stimulate the surrounding soft tissue, leading to a stress response (the adhesion and contraction of soft tissue around the affected area) which causes a large amount of purulent secretion to drain poorly, forcing it to迂回circulate and destroy the deep soft tissue first, forming a sinus.

　　For hand metacarpophalangeal tuberculosis that does not combine with tuberculosis in other parts of the body, there are generally no obvious systemic symptoms. Early local mild swelling, followed by obvious local swelling and increased pain. If the focus breaks into the subcutaneous tissue, the skin may become red and dark. Due to the thinness of the local soft tissue, sometimes the abscess breaks down and forms a sinus tract.

　　Metacarpophalangeal tuberculosis is caused by tuberculosis bacteria through the blood source. There is currently no effective preventive measure for this disease, and early detection and diagnosis are the key to the prevention and treatment of the disease. Pay attention to strengthen nutrition, eat more vegetables, fruits, raw nuts, plant seeds, soy products, and whole grain foods to meet the body's needs for various nutrients.

　　X-ray films of patients with metacarpophalangeal tuberculosis show that the involved metacarpophalangeal bones have new bone formation of the periosteum, thickening of the bone cortex, enlargement of the medullary cavity, and the shaft is梭形swelling or forming bone gas. A few cases may have dead bone, and the new bone hyperplasia in the elderly is not obvious.

　　Patients with metacarpophalangeal tuberculosis should have a light diet, pay attention to eating more vegetables and fruits, and rationally match the diet. Patients can also eat raw nuts, plant seeds, soy products, and whole grain foods to meet the body's needs for various nutrients.

　　The cure rate of tuberculosis of the metacarpophalangeal bones is relatively high, and non-surgical treatment can generally be adopted. Non-surgical treatment for tuberculosis of the metacarpophalangeal bones is very effective, with strengthened nutrition, anti-tuberculosis drug treatment, local appropriate immobilization, the lesions can be cured. For those with poor effects of non-surgical treatment or obvious dead bone locally, surgical treatment can also be adopted, and the debridement of the focus is performed. Tuberculosis of the metacarpal bone can be treated by an arched incision on the back of the hand, and tuberculosis of the phalanx can be treated by a lateral incision on the side of the finger to expose the focus. Postoperative plaster splint immobilization for 3-4 weeks, continue to use anti-tuberculosis drugs for 3 months.