Management of Bone Loss After Multiple Metacarpal and Distal Row Carpal Resection Due to Osteomyelitis

Atraumatic wrist pain can be due to a variety of causes including gout, pseudogout, cellulitis, arthritis flare, or infection of the joint. One important differential to rule out immediately is septic arthritis as it is considered an orthopedic emergency. Due to the rarity of septic arthritis in the wrist, there is limited data to guide diagnosis and treatment. Furthermore, delayed diagnosis of septic arthritis can progress to osteomyelitis and result in severe damage. The primary objective of this study is to present a case of atraumatic septic arthritis with a delayed diagnosis that developed into osteomyelitis in the left wrist and hand of an immunocompetent hand surgeon. In addition, we discuss the surgical treatment including reconstruction of the hand and wrist through a multidisciplinary approach.