To observe the clinical effect of pinknife release guided by visual ultrasound in the treatment of stenotenosynovitis.

A total of 43 patients with stenotenosynovitis were selected from the acupuncture clinic of the First Affiliated Hospital of Guangzhou Medical University from May 2020 to July 2023. The patients with history of chronic strain of the hand, poor flexion and extension of the fingers and localized soreness were included. The patients with stenotenosynovitis combiningpathological changes between the tenosynovitis membrane and the tendon under ultrasound imaging, and severe underlying diseases (i.e. hypertension, diabetes, coronary disease and severecardial, hepatic, renal dysfunctions, history ofhemorrahge tendency, open surgery, and allergic to anesthesia drugs) were excluded.The changes of pain grading index, visual analogue scale, pain intensity evaluation, joint range of motion and treatment satisfaction of the patients undergoing ultrasound-guided pinknife release were compared before treatment, two weeks and three months after treatment. The changes of tendon sheath thickness before and after treatment were observed and compared with the healthy group. The anastomosis between ultrasonic fixed point and pain point was observed and the changes of ultrasonic imagingbefore and after treatment were compared.T test was used to compare pain indices and tendon sheath thickness before and after treatment, chi square test was used to compare the degree of joint mobility limitation and satisfaction.

The study found that patients chose acupotomy after they were not satisfied with the effect of the previous treatment. The score of McGill pain questionnaire showed that there was statistical significance after two weeks of treatment compared with before treatment (t =9.700, 13.824, Z=-6.698, all P<0.05). Patients′ tolerance to pain intensity, nature of pain and fear of pain were significantly improved compared with before treatment. The normal rate of joint mobility disorders reached 60.4% two weeks after treatment and 100% three months after treatment. Patient satisfaction was 62.8% after two weeks and 100% after three months. Before treatment, the tender point of the lesion was consistent with the positive image marks of the lesion under ultrasound. The ultrasonic image of the lesion showed decreased echo and abundant blood flow signal, and the thickness of tendon sheath before treatment was statistically different from that of the healthy group (t=11.473, P<0.05). Three months after treatment, the tender point of the lesion disappeared. The local hypoechoic area disappeared, the signal of rich blood flow decreased, and the thickness of tendon sheath decreased compared with that before treatment (t=1.742, P<0.05), and was similar to that of healthy group (t=1.742, P>0.05), suggesting that the tendon sheath improved with the improvement of circulation after treatment, and the soft tissue environment around the tendon improved.

Ultrasound guided pinknife therapy can directly reflect the changes of tendon and tendon sheath in the internal level, display the precise image of tendon and tendon sheath adhesion, and provide a clear vision for pinknife operation. It can improve the clinical effect of acupotomy in the treatment of stenotendinitis, and provide a new treatment options for the clinical precision treatment of stenotenosynovitis.