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Thomas Pillukat1, M Rahimli1, J Windolf2

  • 1Klinik für Handchirurgie Bad Neustadt an der Saale.

Handchirurgie, Mikrochirurgie, Plastische Chirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Handchirurgie : Organ Der Deutschsprachigen Arbeitsgemeinschaft Fur Mikrochirurgie Der Peripheren Nerven Und Gefasse : Organ Der V
|June 16, 2021
PubMed
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Pyogenic flexor tenosynovitis treatment using closed continuous irrigation shows successful outcomes. This urgent intervention for infected flexor tendon sheaths results in good to excellent function with a low amputation rate.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Hand Surgery

Background:

  • Pyogenic flexor tenosynovitis is a critical condition requiring immediate intervention to prevent tendon necrosis and digit loss.
  • Prompt treatment is essential for preserving finger function and avoiding severe complications.

Purpose of the Study:

  • To evaluate the efficacy of surgical revision combined with postoperative continuous irrigation via a closed system for treating pyogenic flexor tenosynovitis.
  • To assess the functional outcomes and complication rates associated with this treatment approach.

Main Methods:

  • A retrospective study of 54 patients treated for pyogenic flexor tenosynovitis between 2007 and 2016.
  • 33 patients underwent detailed re-examination including range of motion, grip/pinch strength, pain assessment (Numeric Rating Scale), and DASH score.

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  • Surgical revision and closed continuous irrigation were the primary treatment modalities.

    • Main Results:

    • Average hospital stay was 9 days, with 11 patients requiring revision surgery.
    • Re-examined patients achieved 84% grip strength compared to the unaffected side, with low average pain scores (0.2 at rest, 1.2 with activity).
    • Functional outcomes were predominantly good (5 patients) and excellent (26 patients) according to the Buck-Gramcko grading system.

    Conclusions:

    • Closed continuous irrigation following surgical revision is a successful treatment for pyogenic flexor tenosynovitis.
    • The procedure demonstrates a low rate of amputation and yields predominantly good to excellent functional results for patients.
    • This method offers a viable option for managing infected flexor tendon sheaths, preserving hand function.