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Septic Arthritis of the Small Joints of the HandFrom the Department of Orthopaedics and Traumatology, Great Western Hospital, Swindon and Marlborough NHS Trust, Swindon, UK Correspondence: M. Sinha, MS, FRCS Ed.(Tr.& Orth.), 44, Margaret Road, Headington, Oxford, OX3 8NQ, UK. Tel.: +44 01865 428 794; fax: +44 1793 259468. E-mail: maneeshsinha{at}ntlworld.com Twenty-five patients with sepsis of 26 hand joints were treated by urgent debridement, antibiotics and early hand therapy. We reviewed 15 patients (16 joints) in a clinic and three patients by postal questionnaire after a mean follow-up of 54 (range 10–94) months. Of the 26 involved joints, 14 had restricted motion at discharge. Stiffness increased with increase in delay between onset and treatment. At final review, one joint with painful degenerative changes had been fused. Seven patients had regained full movements. The remaining six had some stiffness but, nevertheless, had undergone significant improvement in the ranges of movement. There were two cases with radiological joint degeneration in this group of six patients. Three patients had mild, intermittent pain. No patient had significant disability. While there is significant loss of motion after this joint pathology in the early recovery period, overall motion and function appears to improve over the longer term.
Key Words: Septic arthritis • Hand • Treatment • Pain • Stiffness of joints • Medium term results
Journal of Hand Surgery (British and European Volume), Vol. 31, No. 6,
665-672 (2006) |
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