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Pyogenic flexor tenosynovitis: A current problem of hand surgery.
Konstantin Lipatov1, Arthur Asatryan2, George Melkonyan3
1N.V. Sklifosovsky Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), 119021, Moscow, Russia.
Summary
Early surgical intervention and rehabilitation are crucial for treating pyogenic flexor tenosynovitis, a severe hand infection. Preserving tendon viability leads to the best functional recovery in patients.
Area of Science:
- Hand Surgery
- Infectious Diseases
- Orthopedic Surgery
Background:
- Pyogenic flexor tenosynovitis is a severe hand infection leading to stiffness and contractures.
- Prompt management is essential to prevent long-term functional deficits.
Purpose of the Study:
- To evaluate the outcomes of surgical treatment and early rehabilitation for pyogenic flexor tenosynovitis.
- To identify factors influencing functional recovery in patients with this condition.
Main Methods:
- Retrospective study of 60 patients (18-90 years) with pyogenic flexor tenosynovitis.
- Urgent surgical debridement, drainage, and irrigation followed by early rehabilitation (4-5 days post-op).
- Functional outcomes assessed using the total active motion scale over 3-12 months.
Main Results:
- Tendon necrosis occurred in 13.3% of cases.
- 61.7% of patients had primary suture after initial surgery; 38.3% required repeat debridement.
- Best functional recovery was observed when tendon viability was maintained.
Conclusions:
- Timely diagnosis and comprehensive surgical care are key for successful treatment.
- Early rehabilitation following surgery is critical for optimal outcomes in pyogenic flexor tenosynovitis.
- Maintaining tendon viability during surgery improves functional recovery.
