What is suppurative flexor tenosynovitis?
What is suppurative flexor tenosynovitis?
Pyogenic (suppurative) flexor tenosynovitis (PFT) is a serious diagnosis accounting for up to 10% of acute hand infections. 1. This purulent infection is the result of bacterial invasion of the flexor tendon sheath, a closed anatomic space between the visceral epitenon layer and the outer parietal layer.
Why is flexor tenosynovitis an emergency?
Flexor tenosynovitis caused by infection is an orthopedic emergency. It can cause long-lasting disability through tendon necrosis and permanent digital contracture if unrecognized or mismanaged.
Is flexor tenosynovitis the same as trigger finger?
Trigger finger (also called stenosing flexor tenosynovitis) is caused by a disparity in the size of the flexor tendons and the surrounding retinacular pulley system at the first annular (A1) pulley (figure 1) which overlies the metacarpophalangeal (MCP) joint (figure 2).
What causes tenosynovitis in the hand?
What causes infectious tenosynovitis of the finger, hand, or wrist? The most common cause is an injury that lets germs inside the tendon sheath. These injuries include animal bites, human bites, and puncture wounds. Abuse of IV drugs can also be a cause.
What is the Kanavel sign of flexor tenosynovitis?
Kanavel’s sign is a clinical sign found in patients with infection of a flexor tendon sheath in the hand (pyogenic flexor tenosynovitis), a serious condition which can cause rapid loss of function of the affected finger.
How to treat pyogenic flexor tenosynovitis in hand?
Pyogenic flexor tenosynovitis is an infection of the synovial sheath that surrounds the flexor tendon. Diagnosis is made clinically with the presence of the 4 Kanavel signs. Treatment is urgent irrigation and debridement of the flexor tendon sheath with IV antibiotics.
How to diagnose a Kanavel flexor sheath infection?
Clinical examination confirmed the presence of all four Kanavel signs and he was diagnosed with an RMF flexor sheath infection. He received urgent intravenous flucloxacillin and was taken to the operating theatre the same evening, where exploration of the RMF revealed frank pus within the flexor sheath.
What causes an infection in the palmar space?
Untreated flexor tenosynovitis can cause infection within the palmar spaces The radial bursa is contiguous with the flexor pollicis longus (FPL) tendon sheath while the ulnar bursa communicates with the small finger flexor tendon sheath. Approximately 50% to 80% of people have communicating radial and ulnar bursae.