Acute septic arthritis of the fingers. A clinical study of 87 cases

The authors analyse a clinical series of 87 operated cases of acute septic arthritis of the fingers. Arthritis followed either a direct neglected punctiform inoculation or an adjacent infection (subcutaneous felon), or a serious open wound having received emergency surgery. During surgery a careful assessment was made of the extent of the infection, indicating the condition of the cartilage and that of the articular and periarticular soft tissues. Treatment was either conservative (surgical drainage, synovectomy and closure) or non-conservative (arthrodesis, articular resection or even amputation). The short term results were evaluated on recovery from infection and the long term results (after six months) on the joint function. There is a correlation between the causative factor, the pathology and the prognosis: direct punctiform inoculations operated upon at an early stage and simple joint wounds did not have a regional infection; in all other cases there was one. Conservative treatment was limited to those patients with no regional infection. In these cases, a localized abnormal aspect of the cartilage did not prove to be irreversible. Thus the prognosis was good only in cases of direct punctiform inoculations operated upon at an early stage. In the other cases, either the conservative treatment failed, or a non-conservative treatment was decided upon immediately. Severe joint infection leads to residual lack of motion, and the destruction of the articular surfaces may induce the surgeon to perform an arthrodesis. In the early stages of arthritis, surgical attempts have been made at controlling the infection and preserving articular motion (1, 2). The few works published on that matter deal with larger limb joints. In this paper we present a series of 87 cases of acute septic arthritis of the fingers.