acute suppurative tenosynovitis
Introduction
Introduction to acute suppurative tenosynovitis Acute suppurative tenosynovitis refers to a purulent infection that occurs in the tendon sheath, which occurs mostly in the flexor tendon sheath of the palm of the hand, while the tendon sheath infection of the dorsal extension of the hand is rare. Tenosynovitis that occurs in the thumb can cause suppurative bursitis. Although many infections in the hand may cause serious hand function disorder due to untimely treatment, the destructive and seriousness of suppurative tenosynovitis is more terrible. If the pus in the tendon sheath cannot be drained in time, the sliding device of the tendon will be destroyed, causing rapid Intrathecal tendon adhesion. Tendon function is significantly restricted and causes severe functional loss of the affected finger. Pus can also destroy the blood supply to the tendon, causing tendon necrosis. basic knowledge The proportion of illness: 0.012% Susceptible people: no specific population Mode of infection: non-infectious Complications: purulent finger inflammation
Cause
Causes of acute suppurative tenosynovitis
Suppurative tenosynovitis is caused by tendon sheath stab wounds, intrathecal injections or soft tissue infections in the vicinity. Most of the pathogens are Staphylococcus aureus and Streptococcus.
Prevention
Acute suppurative tenosynovitis prevention
The main concern for patients with this disease is to pay attention to postoperative care:
1. Fix the patient's hand in the functional position, lift it with a sling, and raise the hand when sleeping.
2. Soak in warm sterile liquid before each dressing change.
3. Give appropriate antibiotics.
4. Immediately after the infection control, practice automatic or passive activities to prevent the rigidity of the knuckles. After the tenosynovitis is opened and drained, early activities can reduce tendon adhesion, and physical therapy can promote functional recovery.
5. If the drainage is smooth, but the wound does not heal for a long time, it should be checked for bone or joint infection, or tendon necrosis, if necessary, X-ray examination.
Complication
Acute suppurative tenosynovitis complications Complications purulent finger inflammation
Early treatment is the same as purulent finger inflammation. If there is no improvement after active treatment, if there is no early decompression, the tendon will be vacated and the face will be necrotic.
Symptom
Acute suppurative tendon sheath inflammation Symptoms Palm distraction disappears or slightly bulges Unexplained fever Fever skeletal muscle spasm with chills and severe pain
The disease develops rapidly. After 24 hours, the pain and local inflammatory reaction are more obvious. The typical tenosynovitis signs are:
1. In addition to the distal section, the affected finger showed obvious uniform swelling and extremely intense skin.
2. All joints of the affected finger are slightly curved, often in the relaxed position of the tendon sheath to relieve pain.
3. Any tiny stretched finger movement can cause severe pain.
4. During the examination, there is tenderness along the entire tendon sheath, and the suppurative inflammation is confined within the tough sheath, so there is no fluctuation.
As the infection occurs in the tendon sheath, as with purulent finger inflammation, the pain is very severe, the patient can not fall asleep all night, and at the same time there are systemic symptoms. Suppurative tenosynovitis, if not cut or decompressed in time, intrathecal pus accumulation, pressure Will rapidly increase, resulting in tendon necrosis, loss of function of the finger, inflammation can spread to the deep gap of the hand or through the synovial fluid spread to the wrist and forearm, ulnar synovial sac and temporal sac sac infection, respectively Caused by the little finger and thumb tenosynovitis.
1 foot lateral synovial sac infection: tenderness in the small fish and small finger sheath area, especially at the junction between the small fish and the palm line, the small finger and the ring finger are half-flex, if it is straightened, Causes severe pain.
2 lateral sac infection: the thumb is swollen, slightly flexed, can not be abducted and straightened, the tender area is in the thumb and big fish.
Examine
Examination of acute suppurative tenosynovitis
The auxiliary examination method for this disease is mainly to carry out laboratory tests, which can cause symptoms of infection. Examination of pus can find purulent bacteria, and blood leukocytes can be increased.
Diagnosis
Diagnosis and diagnosis of acute suppurative tenosynovitis
In terms of diagnosis, there are mainly the following points to note:
1. The affected part is obviously swollen, severely painful, and tenderly tender along the tendon sheath.
2. The affected finger is semi-flexed, and the pain of the extension finger is increased.
3. It is often possible to combine infections in the bursae and gaps.
4. May be accompanied by fever, headache and other systemic symptoms.
