J Korean Soc Surg Hand.  2017 Sep;22(3):196-201. 10.12790/jkssh.2017.22.3.196.

Pyogenic Arthritis of the Metacarpophalangeal Joint Treated with External Fixation in Adolescent

• Roh YT
• Kang SH
• Kim HM
• Jeong C
• Lee JY
• Park IJ

• KMID: 2391217
• DOI: http://doi.org/10.12790/jkssh.2017.22.3.196

Abstract

When hand injuries caused by human bite are overlooked and they can progress to pyogenic arthritis. Pyogenic arthritis is difficult to treat and can make severe sequelae in the joints. We report a case of pyogenic arthritis of the hand that occurred after human bite injury in adolescent treated with wide debridement and external fixator. Our literature searches revealed that the use of external fixator is good treatment option for the treatment of pyogenic arthritis of the hand.

Keyword

Adolescent; Metacarpophalangeal joint; Pyogenic arthritis; External fixators

MeSH Terms

Adolescent*
Arthritis*
Bites, Human
Debridement
External Fixators
Hand
Hand Injuries
Humans
Joints
Metacarpophalangeal Joint*

Figure

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  Fig. 1 Clinical photo and radiographs taken 2 weeks after the injury are shown.

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  Fig. 2 Intraoperative clinical photo is shown. Infections in the tendon, radial collateral ligament, and dorsal capsule are visible. Cartilage defects in the metacarpal head and proximal phalanx are also visible.

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  Fig. 3 At 2 weeks after wide debridement, the infection was controlled; however, subluxation and severe instability of the radial side of the metacarpophalangeal joint persisted.

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  Fig. 4 Postoperative radiographs following realignment and stabilization with an external fixator are shown.

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  Fig. 5 Clinical photos taken at 6 years postoperative are shown. There are no deformity and no growth disturbance of the index finger. The metacarpophalangeal joint showed a restricted range of motion of 0°–60°.

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  Fig. 6 Radiographs taken at 6 years postoperative are shown. Nearly normal healing of lesions and the reconstructed metacarpal are visible.

Reference

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