The Orthobullets Podcast Hand⎪Pyogenic Flexor Tenosynovitis
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Aug 23, 2020 Discover the ins and outs of pyogenic flexor tenosynovitis, including its epidemiology and key clinical signs like the Knavel signs. Explore the importance of quick surgical interventions and the benefits of modern treatment techniques, such as closed sheath irrigation. They provide practical case questions to enhance understanding and advocate for ongoing education in orthopedics. This engaging discussion highlights how timely management can lead to better patient outcomes.
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Causes and Microbiology
- Pyogenic flexor tenosynovitis is an infection in the synovial sheath around the flexor tendon, often from penetrating trauma.
- Common pathogens include Staph aureus and MRSA; mixed infections appear in immunocompromised patients or bite wounds.
Horseshoe Abscess Anatomy
- Infection can spread from thumb to little finger sheaths via wrist connections, leading to a horseshoe abscess.
- This anatomical link allows bidirectional infection spread across the hand.
Anatomy of Flexor Tendon Sheaths
- Tendon sheaths vary anatomically; thumb and little finger sheaths extend proximally to wrist bursae.
- Thumb sheath extends from IP joint to radial bursa; little finger sheath to ulnar bursa.