4.0 of 42 Ratings
A 48-year-old hairdresser presents with pain and swelling of his ring finger for 4 days. On examination, there is generalized tenderness along the entire digit. Passive extension of the digit triggers excruciating pain. The clinical appearance of the digit is shown in Figure A. What is the most appropriate next step in management?
Intravenous antibiotics, splinting and elevation
Closed tendon sheath irrigation from the level of the A1 pulley (proximal) to the distal interphalangeal joint (distal)
Continuous closed tendon sheath irrigation from the wrist (proximal) to the distal interphalangeal joint (distal)
Open irrigation and debridement
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A 46-year-old homeless IV drug abuser presents with the hand infection shown in Figure A, which developed after sustaining a superficial laceration. Cultures are taken during operative irrigation and debridement, and he is started on antibiotic therapy. Based on the patients history, what is the most common pathogen in this setting?
Herpes simplex virus
Methicillin-resistant staphylococcus aureus
All of the following are considered the cardinal signs of flexor tenosynovitis EXCEPT:
Tenderness along the flexor tendon sheath
Flexed resting posture of the finger
Fusiform swelling of the finger
Pain on passive extension of the finger
Pain on passive flexion of the finger