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Extensive open drainage for suppurative flexor tenosynovitis involving five digits: a case report
Tun Lin Foo1, Ivan Tjun-Huat Chua, Lester Wai-Mon Chan
1Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore. tun.foo@gmail.com
Summary
A rare case of suppurative tenosynovitis affecting all five digits was successfully treated. Surgical technique ensured infection resolution and functional recovery of the hand.
Area of Science:
- Hand surgery
- Infectious disease
- Orthopedic surgery
Background:
- Suppurative tenosynovitis is a serious infection of the flexor tendon sheath.
- Early diagnosis and aggressive treatment are crucial for preserving function.
Observation:
- A 20-year-old male presented with unusual, extensive suppurative tenosynovitis involving all five digits and distal forearm.
- The patient had no identifiable risk factors for infection.
Findings:
- A surgical strategy utilizing extensile skin incisions from the wrist to all digits enabled thorough debridement of the flexor sheath and synovectomy.
- This approach successfully resolved the infection without compromising skin flap viability.
Implications:
- This case demonstrates an effective surgical approach for extensive tenosynovitis, preserving critical structures.
- Achieving 70% of contralateral hand function at three months highlights the potential for significant functional recovery with appropriate management.
