Techniques for Continuous Catheter Irrigation of a Septic Metacarpophalangeal Joint

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Hand Surgery

Background:

• Septic arthritis of the metacarpophalangeal joint (MCPJ) accounts for 9% of hand infections in Singapore.
• Current standard treatment involves open arthrotomy and joint washout, often leaving the wound open for drainage.
• This approach frequently necessitates repeated debridement and secondary wound closure.

Purpose of the Study:

• To describe a novel method for treating septic MCPJ arthritis using continuous catheter irrigation.
• To evaluate the efficacy of this technique in infection clearance, wound management, and patient outcomes.
• To demonstrate the simplicity, safety, and effectiveness of the procedure.

Main Methods:

• A technique involving continuous catheter irrigation of the septic MCPJ joint using an infant feeding catheter is described.
• The procedure focuses on thorough infection clearance and enabling primary wound closure.
• Case examples illustrate the surgical technique and postoperative management protocols.

Main Results:

• Continuous catheter irrigation achieved significant infection clearance, obviating the need for repeated debridement.
• The method allowed for primary wound closure, avoiding secondary closure procedures.
• Patients experienced reduced postoperative pain, facilitating early joint mobilization and functional recovery.

Conclusions:

• Continuous catheter irrigation is a simple, safe, and effective method for treating septic MCPJ arthritis.
• This technique minimizes surgical interventions and improves functional outcomes.
• The approach offers a promising alternative to traditional open arthrotomy for septic MCPJ infections.