Flexor tenosynovitis

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Background

  • Surgical emergency; flexor sheaths are contiguous w/ deep spaces of the hand
  • Usually associated with penetrating trauma

Clinical Features

  1. Percussion tenderness
    1. Tenderness over entire length of flexor tendon sheath
  2. Uniform swelling
    1. Symmetric finger swelling along length of the tendon sheath
  3. Pain w/ passive extension
  4. Flexion posture
    1. Flexed posture of involved digit at rest to minimize pain

Treatment

  1. Antibiotics
    1. Start immediately
    2. Vanco 1gm IV q12hr + (ampicillin-sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR piperacillin/tazobactam 3.375gm IV q6h)
  2. Consult hand surgery in the ED

See Also

Hand Infection

Source

Tintineli