Hohendorff Bernd, Sauer H, Biber F, Franke J, Spies C K, Müller L P, Ries C
Abteilung für Hand-, Ästhetische und Plastische Chirurgie, Elbe Klinikum Stade, Stade, Germany.
Klinik für Unfallchirurgie und Orthopädie, Elbe Klinikum Stade, Stade, Germany.
Arch Orthop Trauma Surg. 2017 Jan;137(1):141-145. doi: 10.1007/s00402-016-2587-5. Epub 2016 Oct 27.
Digital pyogenic flexor tenosynovitis requires fast, aggressive treatment. Although this infection occurs frequently, treatment consensus is lacking.
Between 2011 and 2015, 22 patients with acute pyogenic flexor tenosynovitis were treated with a single open debridement followed by irrigation; the incision was closed and a 10-day antibiotic course was administered. The average incision-to-suture time was 25 min, and the average hospital stay was 4 days. Recovery was uncomplicated for 20 patients, while two were reoperated, one due to germ resistance and the other due to necrotizing fasciitis. At an average of 30 month postoperatively, 21 of the 22 patients were available for follow-up. The affected finger was inspected, and sensibility, range of motion, and grip force were compared with the opposite side, and the DASH score was determined. Each patient documented pain in the affected finger at rest and during activity, and rated overall satisfaction with the treatment on a visual analogue scale.
Almost all patients were free of pain at follow-up and very satisfied. Compared to the contralateral side, each of the affected fingers had the same range of motion and sensibility. Grip force was similar on both sides. The average DASH score was 35 points.
A single open debridement with irrigation and primary wound closure followed by 10 days of antibiotic treatment resolved uncomplicated pyogenic flexor tenosynovitis. After 2 and a half years, the treatment yielded high patient satisfaction with neither functional nor subjective impairment of the affected finger.
数字化脓性屈指肌腱腱鞘炎需要快速、积极的治疗。尽管这种感染很常见，但缺乏治疗共识。
2011年至2015年期间，22例急性脓性屈指肌腱腱鞘炎患者接受了单次开放性清创术，随后进行冲洗；切口缝合，并给予10天的抗生素疗程。平均切开至缝合时间为25分钟，平均住院时间为4天。20例患者恢复顺利，2例再次手术，1例因细菌耐药，另1例因坏死性筋膜炎。术后平均30个月，22例患者中有21例可进行随访。检查患指，将感觉、活动范围和握力与对侧进行比较，并确定DASH评分。每位患者记录患指在休息和活动时的疼痛情况，并在视觉模拟量表上对治疗的总体满意度进行评分。
几乎所有患者在随访时均无疼痛且非常满意。与对侧相比，各患指的活动范围和感觉相同。两侧握力相似。平均DASH评分为35分。
单次开放性清创术加冲洗及一期伤口缝合，随后进行10天的抗生素治疗，可治愈无并发症的脓性屈指肌腱腱鞘炎。两年半后，该治疗方法使患者满意度较高，患指的功能和主观感觉均未受损。
