Felon

Purulent inflammation of the tissues of the finger. Patients with felon and its complications for a long time lose their ability to work and make up 20-25% of visitors to the surgery clinics.
The causative agent is most often staphylococci, streptococci significantly less frequently observed mixed flora. Minor injuries (scrapes, injections, scratches, splinters, etc.) That do not cause severe pain and therefore do not attract attention to themselves, play an important role in the development of the disease. There are the following types of felon: 1) skin 2) subcutaneous, 3) bone, 4) joint, 5) tendon (tendonitis), 6), paronychia, 7) hyponychial 8) pandaktilit (defeat all the tissues of the finger).
Permanent sign is very severe pain that is associated with structural features of subcutaneous fat finger, its innervation and increased interstitial pressure. Redness on the inside surface of the finger at the felon is weak, and the palm is usually absent. finger and hand function in inflammatory process is broken: the finger is in a half-bent position and attempts to straighten sharply painful. Adjacent healthy fingers may also be in bent position, but the movements are also possible in less painful.
Cutaneous felon. The inflammatory process is localized in the thickness of the skin develops after minor surface damage (a pain, etc..). The epidermis peels exudate, which is illuminated by poverhnostngy layer of the skin. Around purulent focus is often marked by a skin redness and lymphangitis, continuing on the hand and forearm. Treatment operative.
After removing the epidermis in neoslozhennom skin felon is best to apply a bandage to sintomitsinovoy indiferentnoy emulsion or ointment. When skin felon with lymphangitis slightly affected overall. In these cases, after the operation bandage with hypertonic saline and antibiotics administered intramuscularly. The limb is immobilized triangular bandage.
Subcutaneous felon. A common form. The inflammatory process is localized mainly on the nail phalanx, but extends to others.
There necrosis of the tissue and its purulent fusion. Pain, swelling, limitation of mobility of the fingers and sometimes the temperature rise. With all the felon sharp pain is pulsating in nature. Defined feeling finger, local pain allows you to accurately set the point of the greatest changes in the tissues, which is important for opening the chamber, usually bellied probe. When properly conducted cross-section must be detected and treated the place necrosis and purulent fusion of tissues. With the failure of conservative treatment or patient treatment in the midst of the inflammatory process shown urgent surgical intervention, which must be held not later than the first sleepless night sick.
The operation's success is determined by the fullness of pain relief and a good bleeding finger.
Bone felon. There are primary, emerging after the infected puncture wounds with damage to the periosteum or bone, and secondary bone felon, arising as a complication of percutaneous. In the early stages of the same symptoms as the subcutaneous, but expressed more sharply. Characteristically kolboobraznoe thickening of the nail phalanx, sharp pain is determined by palpation. In the study bellied probe Limited no pain, it is celebrated all over the phalanx. He suffers from the general condition of the patient. The temperature rises to 39-40 ± C, marked headache, chills often. On radiographs of destructive changes in the phalanges are found after 10-14 days after the onset of the disease.
Clarify diagnosis during surgery. Initially vigorous antibiotic treatment is carried out, which is administered topically in combination with blockade procaine finger and veins in the back of the hand. Finger and wrist must be immobilized by a plaster splint. In the absence of effect of conservative treatment within 2 days of surgery is indicated. In the early stage of the disease is limited to the opening of the hearth in soft fabrics and careful removal iekrotizirovannoy fiber. On phalanx any manipulations do not produce. The operation complete drainage of the wound. Further treatment is changing and the use of antibiotics.
Articular felon called purulent inflammation of the interphalangeal or metacarpophalangeal joint. Microorganisms can enter into the joint with stab wounds and open lesions or disease occurs as a result of the spread of purulent process in subcutaneous and bone felon, as well as purulent tenosynovitis. In patients with marked severe pain in the finger, his spindly appearance, redness of the skin. Festering process destroys joint lateral ligament and there is an abnormal mobility of it, and then crepitus (crunching). Initially, the process affects only the soft tissue of the joint, then destroyed cartilage and articular surfaces of the phalanges. In the presence of pus joint make arthrotomy: joint autopsied two parallel slits and washed with antibiotics. The subcutaneous tissue is administered to prevent adhesion rubber strip. If the X-ray determined the destruction of the articular surfaces, make their resection. When articular felon first finger is very important to maintain joint mobility. To do this, after surgery to begin earlier movements that promote the formation of a new joint. When running heavy articular felon may require amputation of a finger.