[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.


METHODS
Retrospective, descriptive.


METHODS
Department of Surgery, St Elisabeth Hospital, Tilburg.


METHODS
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.


CONCLUSIONS
In bacterial arthritis of a finger joint, temporary intermittent immobilization using external fixation equipment is certainly worth consideration.
de Vries
H
H
Sint Elisabeth Ziekenhuis, afd. Chirurgie, Tilburg.
van der Werken
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging / Q000601:surgery*; D001424:Bacterial Infections; D016267:External Fixators; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies
Behandeling van purulente artritis van de hand door tijdelijke intermitterende immobilisatie met een externe fixateur.