Tenosynovitis are serious infections and are due to infection of the fibrous sheaths and synovial lining of the flexor tendons of the hand.
Surgical Anatomy
- The radial
- Ulnar bursae.
1. The radial bursa is the smaller of the two and it lines the flexor tendon of the thumb and extends 1-2 cm above the wrist up to the distal end of the tendon.
2. The ulnar bursa encloses the synovial sheaths of the index, middle, ring and little fingers. Distally, those for the index, middle and ring fingers, it extends up to the level of transverse palmar cause; and for the little finger, it extends throughout the length of the tendons. The ulnar bursa encloses tendons of flexor digitorum superficialis and profundus of the above fingers. These two bursae may communicate with each other.
Etiology
Penetrating injuries of the tendon sheaths, extension of the infection from its terminal pulp space, etc. are some of the common modes of infection. The consequences of tenosynovitis are disastrous, as it may lead to adhension, rupture if infection is severe and loss of gliding movements.
Clinical Features
- The patient complains of pain, swelling, and the affected finger is motionless.
- Active or passive extensions of the fingers are very painful.
- The classical local signs include the swelling of the finger through its entire length, flexion of the finger with marked pain on extension, and tenderness over the sheath.
- In tenosynovitis of the little finger, tenderness can be elicited at a point in between the two palmar creases.
Treatment
- Early treatment with antibiotics is started.
- In the early stages of pus formation abscess is drained by a transverse incision at the distal palmar crease and the proximal edge of the sheath is opened.
- Then the sheath is opened distally through a midcarpal incision over the middle phalanx.
- If the infection has progressed far, then a full midlateral incision may be required. Sloughed tendons require excision.
Tenosynovitis is swelling of the coating of the sheath that encompasses a muscular. Symptoms of tenosynovitis include pain, swelling and problems moving the particular combined where the swelling happens. If you are suffering from Tenosynovitis then call now at: (301) 593-7300
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