Aetiology
S. aureus / Strept
- usually a history of trauma
Anatomy
IF / MF / RF
- extend from DP to distal crease
LF
- extends to mid palm
- communicates with ulna bursa
Thumb
- distal phalanx to volar wrist crease
- communicates with radial bursa
Examination
Kanavel's 4 signs
1. Tenderness along course of flexor tendon
2. Fusiform swelling
3. Flexed attitude to finger
4. Pain on passive extension of finger
Management
Nonoperative
May settle with antibiotics if get early
- want improvement in 12 - 24 hours
- risk adhesions / tendon necrosis
Operative
Distal incision
- distal finger crease
Proximal incision
- distal palmar crease
Will see pus
- take swab for MCS
Pass infant feeding catheter
- into flexor sheath
- irrigate +++
IV ABx 48 hours
Occupational / hand therapy to prevent adhesions