Description

• An inflammation of the flexor tendon sheath leading to a stenosing tenosynovitis
• Patients experience locking or catching sensation during active flexion extension activity and often have a palpable nodule along the axis of the flexor tendon
• It results from the constriction of the fibrous digital sheath, so that free gliding of the contained flexor tendon does not occur
• Inflammation and hypertrophy of the retinacular sheath progressively restricts the motion of the flexor tendon 

Types

• In adults – middle finger or ring finger is most affected
• In children – thumb is affected commonly (stenosing tenosynovitis of flexor pollicis longus)
• Pain at the base of the affected finger, especially on trying to passively extend the finger
• Locking of finger in flexed position which releases suddenly with a snap/pop on extension

Investigation

• O/E – tendon nodule can be felt on the affected finger in front of the metacarpo-phalangeal joint
• Tenderness over the flexor tendon sheath in the palm of hand

Treatments

• Rest- to prevent over use of affected finger
• Splinting – to keep the affected finger in extended position
• In early stages, local ultrasonic therapy provides relief
• Local injection of hydrocortisone relieves the pain
• Operative – longitudinal incision of fibrous sheath

Ayurvedic Treatment

Internal medicines

• Amrutothara kashaya
• Punarnavadi kashaya
• Maharasnadi kashaya
• Simhanada guggulu
• Hinguvachadi choorna
• Gandha taila

Procedure

• Karuthavattu (E/A)
• Dhara- Murivenna, Dhanwantara taila, Ksheerabala taila
• Agni karma (snigdha or ruksha)

Department

Salya Tantra