Treatment of tenosynovitis

1. Stenosing tenosynovitis of styloid process of radius

For those who are newly diagnosed or have mild symptoms, braking, physical therapy or local closed conservative treatment can be used. If there is no obvious improvement or recurrence of symptoms after non-surgical treatment, surgical treatment can be used. Surgical treatment is not completed by cutting the first sheath at the back of the wrist. Also check whether there is anatomical variation in the sheath, and if there is, remove the redundant part. If there is tendon adhesion here, it should be released at the same time. Because the superficial branch of radial nerve and its branches pass through here, attention should be paid to protect it from injury during operation.

2. Stenosing tenosynovitis of flexor tendon

(1) Physiotherapy or local blocking therapy is mostly effective in the early stage of the lesion.

(2) If the lesion is serious or recurrent, the author can resect the thickened narrow ring by surgery, and observe the resection range of the thickened flexor tendon that is not covered by the sheath during finger flexion and extension.

3. Myositis

Wrist immobilization, local hot compress, local physical therapy or local closure when necessary, most symptoms can disappear; If it recurs for a long time, the peritendinous and synovial tissues become thicker, and the local uplift can be considered for surgical treatment, and the thickened synovium and fascia can be removed.

4. Tenosynovitis of extensor carpi ulnaris

Early fixation or local closure is needed, and synoviectomy or partial sheath resection is used in the later operation. Similarly, flexor carpi radialis and flexor carpi ulnaris can also have similar symptoms, which are often caused by tenosynovitis. If it recurs, patients can also consider surgical treatment.