Flexor Tenosynovitis - Clinical Scenario

A 40-year-old, right-hand dominant, tree surgeon with left index finger pain that is exacerbated by passive extension. He received a direct puncture wound 24 hours prior to presentation. No medical history of note, with the patient being otherwise fit and well.

Objectives:
1. Early recognition of flexor sheath infection.
2. Anatomy of the flexor sheath and radioulnar bursa of the hand.
3. Describe emergent nonoperative and operative management.
4. Understand the microbiology of flexor sheath infections.


Primary Contributor:
Dr Suzanne Thomson, Plastic Surgeon, Scotland.

Reviewer:
Dr Kurt Lee Chircop, Plastic Surgery Trainee, Malta.