[Septic arthritis of finger joints].
OBJECTIVE
Septic arthritis of finger joints is rare and its management not standardized. The outcome of all consecutive patients with finger joint arthritis was analyzed in terms of risk factors, surgical technique, antimicrobial therapy and hand therapy.


METHODS
Data of 31 patients with surgical treatment between 1993 and 2005 were screened and those from 29 patients with > 1 year of follow-up were retrospectively analyzed. Surgical techniques were debridement, primary, secondary arthrodesis or temporary joint distraction with external fixation. In addition, all patients were treated with antibiotics and hand physiotherapy. The median follow-up of the 29 patients was 5.7 years.


RESULTS
The most frequent cause was work injury (19/29), the leading causing agent Staphylococcus aureus (9/29). Overall 16/29 (55 %) of the patients with follow-up had a good result regarding healing of infection, lack of pain and fair function. Primary arthrodesis was performed in 3, secondary arthrodesis in 4 patients. 3 patients were treated with temporary external fixation for three weeks. Cartilage damage detected during surgery (p = 0.01) was the significant risk factor for a bad outcome. The median delay to treatment was 4 days (1 - 550 days). Antibiotics were given for a median of 2 days by the iv-route and 17 days orally.


CONCLUSIONS
Septic arthritis of finger joints should be early recognized and immediately treated with surgery and antibiotics, in order to avoid cartilage damage. If cartilage is already damaged, primary arthrodesis with the use of an external fixation is indicated.
Angly
B
B
Handchirurgische Abteilung, Orthopädische Klinik, Kantonsspital Liestal, Rheinstrasse 26, 4410 Liestal, Switzerland.
Steiger
R
R
Zimmerli
W
W
D000062:Accidents, Occupational; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D001174:Arthrodesis; D003627:Data Interpretation, Statistical; D016267:External Fixators; D005260:Female; D005383:Finger Injuries / Q000150:complications* / Q000209:etiology; D005384:Finger Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents