Infections Of The Finger - Everything You Need To Know - Dr. Nabil Ebraheim
Dr. Ebraheim’s educational animated video describes the condition of infection of the finger.
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Infections of the Finger
Infection of the finger is common, and it can vary in severity. Serious infection of the fingers will require urgent surgical care.
Felon is a deep infection of the soft pad, or pulp, of the fingertips. It is usually the result of a puncture wound. Swelling or pus is trapped in the small compartments of the pulp or the tip of the finger. Symptoms include unusual redness or swelling, firm swelling, throbbing pain at the tip of the finger, or visible yellowish area of puss. If the infection goes untreated, it may lead to severe symptoms such as skin necrosis, flexor tenosynovitis, osteomyelitis, and arthritis of the distal interphalangeal joint. Surgery is the usual treatment in the form of incision and drainage of the felon. If there is no foreign body in the finger, you will do the midaxial incision or the “J shaped” incision, and you will leave the wound open. If there is a foreign body present, such as a splinter or a thorn, you will do the volar longitudinal incision. Try to avoid doing the “fish mouth” incision; it will lead to unstable finger pulp.
Symptoms of paronychia include swelling, redness, puss formation, and pain in the soft tissue around the nail plate. Treatment is antibiotics if the infection is caught early. Surgery is the usual treatment. Incision and drainage with or without partial nail removal for subungual abscess.
Herpetic Whitlow is a painful infection caused by the herpes simplex virus that usually affects the fingers or the thumb. It is seen in dentists, respiratory therapists, anesthesiologists, and toddlers (children who suck their thumb). Symptoms include swelling, tenderness, redness, fever, swollen lymph nodes, burning pain, and vesicle formation on the finger. It can be grouped together with inflammation and redness at the base of the finger. The fluid in the vesicle is usually clear (not purulent). The infection is self-limiting. Conservative treatments include antiviral treatments applied to the skin (acyclovir). Antibiotics are not used unless secondary infection is present. Do not do surgery, surgery can make the situation worse.
Flexor tenosynovitis is a relatively common infection of the hand usually caused by Staphylococcus aureus. It usually occurs due to prior penetrating trauma and infection. The index, middle, and ring fingers are most commonly affected. Symptoms include painful swelling of the finger that hurts worse with motion. Flexor tenosynovitis has Kanavel’s four cardinal signs: uniform swelling of the entire finger (fusiform swelling, finger looks like a sausage), the finger is flexed, intense pain when attempting to straighten the finger (occurs early), tenderness along the course of the tendon sheath (most important sign). If the infection is caught early, treat with IV antibiotics. If the infection is severe, do early open drainage of the infection to avoid skin loss, tendon necrosis, and osteomyelitis. Surgical incisions used to drain the flexor sheath infection. Use a midaxial or Bruner incision. Use two small incisions, one proximally at A1 pulley and one distally at A5 pulley. Use an angiocath for irrigation. Give culture specific IV antibiotics. Infection may spread from the tendon into the deep palmar space or into the Parona’s space in the forearm. The little finger communicates with the ulnar bursa. The thumb communicates with the radial bursa. The radial and ulnar bursa communicate proximal to the carpal tunnel. Infection may travel from the little finger into the ulnar bursa to the Parona’s space. Infection can also travel from the thumb into the radial bursa to the Parona’s space. Infection may cause “horse shoe” tenosynovitis. Infection travels from the thumb through the radial bursa to the ulnar bursa infecting the little finger. May need combination of incisions for drainage.
Видео Infections Of The Finger - Everything You Need To Know - Dr. Nabil Ebraheim канала nabil ebraheim
Follow me on twitter:
https://twitter.com/#!/DrEbraheim_UTMC
Find me on Instagram @OrthoInitiative
Infections of the Finger
Infection of the finger is common, and it can vary in severity. Serious infection of the fingers will require urgent surgical care.
Felon is a deep infection of the soft pad, or pulp, of the fingertips. It is usually the result of a puncture wound. Swelling or pus is trapped in the small compartments of the pulp or the tip of the finger. Symptoms include unusual redness or swelling, firm swelling, throbbing pain at the tip of the finger, or visible yellowish area of puss. If the infection goes untreated, it may lead to severe symptoms such as skin necrosis, flexor tenosynovitis, osteomyelitis, and arthritis of the distal interphalangeal joint. Surgery is the usual treatment in the form of incision and drainage of the felon. If there is no foreign body in the finger, you will do the midaxial incision or the “J shaped” incision, and you will leave the wound open. If there is a foreign body present, such as a splinter or a thorn, you will do the volar longitudinal incision. Try to avoid doing the “fish mouth” incision; it will lead to unstable finger pulp.
Symptoms of paronychia include swelling, redness, puss formation, and pain in the soft tissue around the nail plate. Treatment is antibiotics if the infection is caught early. Surgery is the usual treatment. Incision and drainage with or without partial nail removal for subungual abscess.
Herpetic Whitlow is a painful infection caused by the herpes simplex virus that usually affects the fingers or the thumb. It is seen in dentists, respiratory therapists, anesthesiologists, and toddlers (children who suck their thumb). Symptoms include swelling, tenderness, redness, fever, swollen lymph nodes, burning pain, and vesicle formation on the finger. It can be grouped together with inflammation and redness at the base of the finger. The fluid in the vesicle is usually clear (not purulent). The infection is self-limiting. Conservative treatments include antiviral treatments applied to the skin (acyclovir). Antibiotics are not used unless secondary infection is present. Do not do surgery, surgery can make the situation worse.
Flexor tenosynovitis is a relatively common infection of the hand usually caused by Staphylococcus aureus. It usually occurs due to prior penetrating trauma and infection. The index, middle, and ring fingers are most commonly affected. Symptoms include painful swelling of the finger that hurts worse with motion. Flexor tenosynovitis has Kanavel’s four cardinal signs: uniform swelling of the entire finger (fusiform swelling, finger looks like a sausage), the finger is flexed, intense pain when attempting to straighten the finger (occurs early), tenderness along the course of the tendon sheath (most important sign). If the infection is caught early, treat with IV antibiotics. If the infection is severe, do early open drainage of the infection to avoid skin loss, tendon necrosis, and osteomyelitis. Surgical incisions used to drain the flexor sheath infection. Use a midaxial or Bruner incision. Use two small incisions, one proximally at A1 pulley and one distally at A5 pulley. Use an angiocath for irrigation. Give culture specific IV antibiotics. Infection may spread from the tendon into the deep palmar space or into the Parona’s space in the forearm. The little finger communicates with the ulnar bursa. The thumb communicates with the radial bursa. The radial and ulnar bursa communicate proximal to the carpal tunnel. Infection may travel from the little finger into the ulnar bursa to the Parona’s space. Infection can also travel from the thumb into the radial bursa to the Parona’s space. Infection may cause “horse shoe” tenosynovitis. Infection travels from the thumb through the radial bursa to the ulnar bursa infecting the little finger. May need combination of incisions for drainage.
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