[Treatment of septic arthritis of the hand using temporary intermittent immobilization with an external fixator].

OBJECTIVE

To evaluate the treatment of a bacterial infection of a finger joint with incision, drainage and intermittent immobilization using external fixation apparatus.

DESIGN

Retrospective, descriptive.

SETTING

Department of Surgery, St Elisabeth Hospital, Tilburg.

METHOD

In eight males and two females (median age 37 years) with acute bacterial arthritis of a finger joint, this joint was opened surgically, washed out and then immobilized using mini-external fixation equipment, for about 3 weeks. The fixator was unscrewed daily so that the patient could move the finger in water, with the purpose of mechanical cleansing of the joint; the intermittent pressure that occurs in the cartilage during movement is supposed to promote the removal of debris. Subsequently, the finger was fixed in alternating positions to prevent adhesions. Mean duration of follow-up was 48 months (11-78).

RESULTS

Arthrodesis had to be carried out in one patient because of persistent arthritis and tissue necrosis, while in one other, part of the finger was amputated. The other eight patients showed good final results, without symptoms.

CONCLUSION

In bacterial arthritis of a finger joint, temporary intermittent immobilization using external fixation equipment is certainly worth consideration.