Arch Hand Microsurg.  2020 Sep;25(3):189-200. 10.12790/ahm.20.0038.

Surgical Outcomes of Bacterial Infection of the Finger Bone and Joint

Affiliations
  • 1Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea

Abstract

Purpose
This study aimed to describe the surgical outcomes of bacterial infection of the finger bone and joint.
Methods
We retrospectively reviewed 31 cases of finger bone and joint bacterial infection from December 2016 to December 2019. Demographic information, finger infection details, treatment details, and range of motion (ROM) at the last follow-up were analyzed.
Results
Twenty (64.5%) of the 31 cases showed normal values in preoperative erythrocyte sedimentation rate and C-reactive protein level. Staphylococcus aureus (15 cases) was the most common pathogen. For the initial operative treatments, 21 cases were treated with incision and debridement with bone curettage or drilling, and seven with amputation. Seventeen patients underwent delayed wound closure after the initial surgery, of whom 16 did not have recurrent infections after wound closure. The mean number of operations was 2.1±1.3 in all cases. The median ROM of the involved finger was 57.7% (range, 26.9%–76.9%) and 88.8% (range, 34.6%–100%) of the contralateral side in the patients with and without initial septic arthritis, respectively (p=0.002). Twenty-nine cases (93.5% of 31 cases) showed no infection recurrence after completion of the treatments.
Conclusion
Combined antibiotic and surgical treatments showed a high cure rate, but initial septic arthritis was a poor prognostic factor of ROM. The soft tissue condition of the involved finger is important for deciding the surgical treatment.

Keyword

Fingers; Osteomyelitis; Infectious arthritis; Amputation; Arthrodesis
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