Tenosynovitis Supuratif

Dr. Andi Dhedie P. Sam, M.Kes, Sp.OT

Pyogenic FTS

 Potential to result in severe, permanent

disability
 Purulence within tendon sheath destroys
gliding mechanism.
Pyogenic FTS

 Adhesions form quickly causing marked

limitation of tendon function, severe loss of
motion.
 Also destroys blood supply>>tendon
necrosis
Pyogenic FTS

 Infections usually caused by penetrating

injury, but may be hematogenous in origin
 Ring, middle, index fingers most commonly
involved
 Most common infecting organism>> S.
aureus
Pyogenic FTS
 Kanaval described 4 classic signs
 >Flexed position of finger
 >Symmetric enlargement of whole finger
 >excessive tenderness over course of
sheath, but limited to sheath
 >Pain with passive extension, most marked
proximally--considered most valuable, often
earliest sign
Pyogenic FTS
 If seen within first 24-48 hrs process can be
aborted
 Treatment includes high dose abx,
immobilization of entire hand and all digits,
elevation, and close observation
 If not resolved within 48 hrs or pt presents
>48 hrs after onset, surgical drainage
necessary.
FTS
Surgical approaches
Pyogenic FTS
post-op management

 Active finger motion started as soon as

possible- 36-48 hrs
 Whirlpool, irrigation treatments
 Resolution of drainage generally prolonged,
so secondary wound healing instead of DPC
to minimize recurrence
Thank You