Palmar pyogenic tenosynovitis, bursitis, and deep space infections

　　The causes of palmar pyogenic tenosynovitis, bursitis, and deep space infection include the following: 7. Conventional Western medical treatment methods for palmar pyogenic tenosynovitis, bursitis, and deep space infection.

　　The causative bacteria of palmar pyogenic tenosynovitis, bursitis, and deep space infection are Staphylococcus aureus. They are often infected after being pierced on the palm, such as by foreign bodies, tenosynovial injections, etc. Bursitis or deep space infection may also occur directly after palm injury. The complications caused by this disease mainly include the following.

　　1, Tendinous necrosis: The accumulation of pus within the sheath leads to rapid increase in pressure, causing tendinous ischemia and necrosis, manifesting as loss of function in the affected finger.

　　2, Finger extension dysfunction: It is often caused by inappropriate choice of surgical incision, tenosynovitis during surgery, adhesion and skin scar contracture after surgery.

　　Patients with pyogenic tenosynovitis experience pain and swelling mainly in the middle and proximal phalanges of the affected finger, with the skin being significantly tense. The finger joints are slightly flexed, and it is almost unbearable to extend them. Touching the tendons outside also exacerbates the pain. If not treated promptly, the lesion may spread to the deep palm, resulting in possible tendinous necrosis and loss of finger function.

　　Pyogenic bursitis usually involves radial bursitis and tenosynovitis of the thumb, causing swelling and slight flexion of the thumb, inability to extend and abduct, and tenderness over the middle segment of the thumb and the thenar eminence. Ulnar bursitis is often associated with tenosynovitis of the little finger, causing swelling of the little finger, along with the ring finger in a semi-flexed position, with tenderness over the little finger and hypothenar eminence. When inflammation intensifies, swelling extends towards the wrist.

　　The palmar interosseous space infection in patients with deep space infection can be exacerbated by tenosynovitis of the index finger or caused by infection after local palm injury. The thenar eminence and 'hollow of the hand' (web between thumb and index finger) have swelling, pain, and tenderness, with the index and thumb slightly flexed, causing severe pain when extended. Palmar interosseous space infection can be exacerbated by tenosynovitis of the middle and ring fingers or caused by infection after local palm injury. The swelling of the palm makes the original concavity flat, with white skin, pain, and tenderness, and the swelling of the palmar back and web is more obvious than that of the palm. The middle, ring, and little fingers are all flexed, with severe pain when extended.

　　The pressure in the lesion tissue of suppurative tenosynovitis, bursitis, and deep space infections on the palmar side is relatively high, so it is easy to cause symptoms such as chills, fever, and general discomfort, and may also lead to lymph node enlargement in the elbow or axilla with tenderness.

　　In the prevention of suppurative tenosynovitis, bursitis, and deep space infections on the palmar side, attention should be paid to the treatment of minor hand injuries, strict aseptic operation procedures should be followed for intrasynovial injections, early symptoms of finger infection should be detected in a timely manner, and early treatment should be initiated actively to control the progression of infection.

　　When the systemic toxic symptoms of patients with suppurative tenosynovitis, bursitis, and deep space infections on the palmar side are severe, there may be an increase in white blood cell count, and the change in neutrophils is positively correlated with the white blood cell count.

　　Patients with suppurative tenosynovitis, bursitis, and deep space infections on the palmar side should pay attention not to have a single偏食. Eat in moderation, do not overeat or undereat, and quit smoking and drinking. Patients should increase their intake of calcium, eat high-calcium foods such as milk, eggs, soy products, vegetables, and fruits, and supplement calcium agents if necessary. Patients should also increase their intake of various vitamins, such as vitamins A and D. Avoid intake of sugar, alcohol, coffee, etc., as these substances will hinder the recovery process and disturb the mineral balance in the body.

　　For patients with suppurative tenosynovitis, bursitis, and deep space infections on the palmar side, early systemic application of antibiotics such as trimethoprim (sulfamethoxazole) orally or penicillin injection is recommended. The affected finger should be fixed in a functional position and immobilized for rest. For those with severe systemic reactions, traditional Chinese medicine such as Yin Qiao San, Huang Lian Jie Du Tang, etc., should be used in combination with treatment. Local treatment should be given early with physical therapy such as ultraviolet light, microwave, and infrared light, or external application of Yiguang Huangjin San, Yushi Zhi, etc. For those with severe pain despite active treatment, early decompression incision should be performed to prevent tendons from being compressed and necrotic.