The infection that occurs within the body are quite common, but certain types of infections can be considered serious and have significant consequences. A type of infection that is serious is known as flexor tenosynovitis or flexor tendon sheath infection. Remember that these infections develop around the tendons of the finger. Before surgery and antibiotic treatment, flexor tendon sheath infection can often lead to loss of a limb or death.
At the present, this type of infection can be treated but in order to prevent significant disability, it should be recognized quickly and treated aggressively.
What are the flexor tendons?
The flexor tendons are the tendons of the fingers. It is important to note that the flexor tendon runs part of their full course through the flexor tendon sheath. The flexor tendon sheath exits due to two reasons. First, it enables smooth gliding of the tendon and second, the flexor sheath helps prevent the tendons from “bowstringing”. Take note that “bowstringing” occurs if the sheath were not supporting the tendon alongside the bone. In such cases, the tendon is pulled in a straight line which is not helping the finger and will not get in the way of holding objects.
What is flexor tendon sheath infection?
In most cases, a flexor sheath infection develops after an injury to the finger, penetrating trauma or deep wound. In case bacteria are introduced into the sheath, the body has reduced ability to fight off the infection. Remember that there is no blood supply to the lubricating synovial fluid inside the tendon sheath, thus the immune system of the body is ineffective.
The indications of infection typically develop within a week of the injury and characterized by the following:
- Inflammation of the finger
- Soreness along the tendon sheath
- Pain upon movement of the finger
- Diminished movement with the finger bent slightly
These are known as the “Kanavel’s cardinal signs” and an individual with these signs must be assessed by a doctor. Remember that these physical signs are vital in creating a diagnosis of flexor tendon sheath infection.
Management of flexor tendon sheath infection
As stated earlier, the vital step is to recognize the issue right away and start treatment as soon as possible. Most cases of infections of the flexor tendon sheath are caused by staph and strep bacteria.
Remember that antibiotic treatment is vital but this is not enough. This is due to the fact that the body sends limited blood supply to the flexor tendon sheath, thus antibiotics cannot reach the location easily. Surgery is also required to clean out the infection from the sheath.
The surgery to clean out the flexor tendon sheath can be achieved by creating two small-sized incisions. Saline fluid is washed via the sheath to clear out the infection. Those who have advanced infection might require full exposure of the sheath surgically to clean it out.