Hyatt Brad T, Bagg Mark R
The Hand Center of San Antonio, 21 Spurs Lane, San Antonio, TX 78240, USA.
The Hand Center of San Antonio, 21 Spurs Lane, San Antonio, TX 78240, USA.
Orthop Clin North Am. 2017 Apr;48(2):217-227. doi: 10.1016/j.ocl.2016.12.010.
For patients with suspected flexor tenosynovitis, the mainstay of diagnosis is a thorough history and physical examination. The examination is guided by evaluating the patient for Kanavel's four cardinal signs. Empiric antibiotics should be started immediately on diagnosis covering skin flora and gram-negative bacteria. Typically, surgery is required. Appropriate exposure is required for adequate treatment and incisions should be tailored to preserve areas of skin compromised from draining sinuses and abscess pressure. Diabetes mellitus and peripheral vascular disease place patients at higher risk of poor outcomes including stiffness and amputation; early administration of antibiotics is the intervention that correlates most closely with good outcomes.
对于疑似屈指肌腱腱鞘炎的患者，诊断的主要依据是详尽的病史和体格检查。检查以评估患者是否存在卡纳韦尔氏四大主要体征为指导。一旦确诊，应立即开始经验性使用抗生素，覆盖皮肤菌群和革兰氏阴性菌。通常需要进行手术。为了充分治疗，需要适当的手术显露，切口应根据情况进行调整，以保护因引流窦和脓肿压迫而受损的皮肤区域。糖尿病和周围血管疾病会使患者出现包括僵硬和截肢在内不良后果的风险更高；早期使用抗生素是与良好预后最密切相关的干预措施。
