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The major alkaloid content of kratom leaves is mitragynine, which binds to opioid receptors to give opioid-like effects

For example, it may be: Pulled off its attachment at the base of the first bone (the proximal phalanx) in the thumb Pulled off the metacarpal bone, where it originates Torn through its middle, though this is less common Cause Any strong force that bends the thumb backward and away from the palm of the hand can stretch or tear the ulnar collateral ligament

For patients with early stage of HCC, surgical resection is the most commonly used therapeutic approach, with 5-year survival of 38% 61% [11,12,13]