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PYOGENIC FLEXOR TENOSYNOVITIS: ONE YEAR'S EXPERIENCE AT A UK HAND UNIT AND A REVIEW OF THE CURRENT LITERATURE

2012; World Scientific; Volume: 17; Issue: 02 Linguagem: Inglês

10.1142/s0218810412500190

1793-6535

Dariush Nikkhah, Jeremy Rodrigues, Khabab Osman, Lodewikus DeJager,

Musculoskeletal synovial abnormalities and treatments

We report outcomes and learning points from flexor sheath infection (FSI) cases presenting over one year to a United Kingdom (UK) hand unit. Between August 2009 and August 2010, 16 FSIs were confirmed from operation note findings. Patient age ranged from 12 to 82 years. All patients were posted a quickDASH questionnaire. In all cases, surgery was performed within 24 hours, via distal and palmar incisions, with 0.9% saline irrigation. Seven patients (44%) responded to questionnaires. Of these, most achieved a good functional outcome, with a mean quickDASH of 7.14. Four cases (25%) had no triggering event. Beta-haemolytic streptococcus was cultured in three cases (18%). Its presence was significantly associated with a requirement for multiple operations (p < 0.032), and with prolonged admission of up to nine days (p < 0.009). We suggest that close liaison with microbiology services and early identification of beta-haemolytic streptococcus may predict the need for multiple washouts in FSI.