Purulent inflammation of the tendon sheaths develops as a result of the direct entry of microorganisms into them or as a result of the transition of the inflammatory process in case of purulent felon. Tendovaginitis - the most severe type of felon, causing, as a rule, changes in the general condition of the patient and leading to prolonged dysfunction of the hand.
Tendon sheaths of II, III, IV fingers begin at the base of the nail phalanges and end with blind bags. The tendon sheaths of the 1 and V fingers also begin at the base of the nail phalanges, but their ends are not blindly attached, but communicate with the synovial bags of the palm, the radial and ulna. Purulent tendovaginitis II, III, and IV fingers are characterized by swelling of the finger, its bent position, restriction of active movements, especially severe pain when moving, when trying to bend and when pressed with a pushy probe along the tendon. Patients complain of indisposition, headache, fever.
Treatment:In the first hours of the disease, puncture of the tendon sheath with the evacuation of the exudate and the subsequent administration of antibiotics is recommended. Puncture do on the main phalanx of the finger. The tendon sheath holds no more than 1.5-2 ml of fluid, so antibiotics are taken in high concentration. To eliminate pain, it is better to administer the drug under general anesthesia.
In the absence of success of conservative treatment, an operation is shown that is performed in a hospital.
The wounds are drained by rubber graduates, they are held over the tendon, so as not to damage the mesentery, which can cause tendon necrosis. Hand and finger fix plaster longuge. After 2 days, graduates are removed and treated with physiotherapy procedures and gymnastics.