Diferencia entre revisiones de «Flexor tenosynovitis»
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Sin resumen de edición |
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==Clinical Features== | ==Clinical Features== | ||
===Kanavel's Signs=== | |||
#Percussion tenderness | #Percussion tenderness | ||
#*Tenderness over entire length of flexor tendon sheath | #*Tenderness over entire length of flexor tendon sheath | ||
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==Management== | ==Management== | ||
#Antibiotics | #[[Antibiotics]] (start immediately) | ||
#*[[Vancomycin]] 1gm IV q12hr + ([[Ampicillin/Sulbactam]] 1.5gm IV q6h OR [[cefoxitin]] 2gm IV q8h OR [[Piperacillin/Tazobactam]] 3.375gm IV q6h) | |||
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#Consult hand surgery in the ED | #Consult hand surgery in the ED | ||
Revisión del 02:35 10 mar 2015
Background
- Surgical emergency; flexor sheaths are contiguous w/ deep spaces of the hand
- Usually associated with penetrating trauma
Clinical Features
- Percussion tenderness
- Tenderness over entire length of flexor tendon sheath
- Uniform swelling
- Symmetric finger swelling along length of the tendon sheath
- Pain w/ passive extension
- Often the first sign seen
- Flexion posture
- Flexed posture of involved digit at rest to minimize pain
Differential Diagnosis
Hand and finger infections
- Bed bugs
- Closed fist infection (Fight Bite)
- Hand cellulitis
- Hand deep space infection
- Hand-foot-and-mouth disease
- Herpetic whitlow
- Felon
- Flexor tenosynovitis
- Paronychia
- Scabies
- Sporotrichosis
Look-Alikes
Workup
W/U should be an adjunct to a clinical diagnosis
- CBC
- ESR
- Ultrasound
- Xray
Management
- Antibiotics (start immediately)
- Vancomycin 1gm IV q12hr + (Ampicillin/Sulbactam 1.5gm IV q6h OR cefoxitin 2gm IV q8h OR Piperacillin/Tazobactam 3.375gm IV q6h)
- Consult hand surgery in the ED
Disposition
- Typically require I&D in the OR
See Also
External Links
Sources
- Tintinalli