The authors reviewed 25 patients (26 cases) with metacarpophalangeal and/or interphalangeal joint sepsis who were treated by debridement, antibiotics, and early hand therapy. All patients were treated within 6 days of symptom onset. Oral antibiotics were prescribed for an average of 4.2 weeks (range 3.4 to 6 weeks), whereas the duration of intravenous antibiotic treatment was not specified. Outcome measurements were obtained in 16 cases at a mean time from surgery of 54 months (range 10 to 94 months). The average total active motion of the digit was 82% of normal finger motion. Degenerative joint changes were detected in 2 cases with follow-up radiographs (not all cases were imaged).
Surgical drainage and antibiotic therapy are well-accepted tools in managing small joint sepsis. However, there is little scientific data to guide the appropriate duration of intravenous and/or oral antibiotic therapy. The authors of this study highlight the potential for developing finger stiffness following successful eradication of a small joint infection.
Joint, Sepsis, Pyarthrosis, Antibiotics, Arthritis
Journal of Hand Surgery