Review Question - QID 220110

A 57-year-old male presents to the emergency room with a three-day history of worsening right index finger pain and swelling. On examination, there is fusiform swelling of the right index finger, which is held in a flexed position at rest. He has tenderness overlying the flexor tendon sheath and severe pain with attempted passive extension of the digit, and is brought to the operating room expeditiously for surgical irrigation and debridement. At the time of surgery, purulence is encountered within the flexor tendon sheath, which does not extend into the overlying subcutaneous tissues. Intraoperative cultures grow methicillin-resistant staph aureus (MRSA) and he is started on an appropriate antibiotic therapy regimen. Which of the following factors places this patient at a greater risk for postoperative stiffness and the potential need for future amputation?