Flexor tenosynovitis: Difference between revisions
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Revision as of 22:07, 17 November 2014
Background
- Surgical emergency; flexor sheaths are contiguous w/ deep spaces of the hand
- Usually associated with penetrating trauma
Clinical Features
- Kanavel's Signs:
- Percussion tenderness
- Tenderness over entire length of flexor tendon sheath
- Uniform swelling
- Symmetric finger swelling along length of the tendon sheath
- Pain w/ passive extension
- Flexion posture
- Flexed posture of involved digit at rest to minimize pain
DDX
Hand and finger infections
- Bed bugs
- Closed fist infection (Fight Bite)
- Hand cellulitis
- Hand deep space infection
- Hand-foot-and-mouth disease
- Herpetic whitlow
- Felon
- Flexor tenosynovitis
- Paronychia
- Scabies
- Sporotrichosis
Look-Alikes
Treatment
- Antibiotics
- Start immediately
- Vancomycin 1gm IV q12hr + (Ampicillin/Sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR Piperacillin/Tazobactam 3.375gm IV q6h)
- Consult hand surgery in the ED
See Also
Source
- Tintinalli