4
Unfallschirurgie (Fach) / Handchirurgie (Lektion)
- Paronychia - infection of the lateral nail fold - pus underneath eponychial fold - mostly caused by staphylococcus aureus Treatment:- conservative- separation of the lateral nail fold DD: Herpes whitlow
- Felon - subcutaneous abscess in a closed space of the pulp of a finger - mostly caused by staphylococcus aureus - can extend in osteomyelitis DD: pyogenic flexor tenosynovitis Treatment:- conservative- incision and open wound treatment- 2nd look in 48 h
- Pyogenic flexor tenosynovitis - closed-space infection in the flexor tendon sheath of the digits II, III, IV - mostly caused by staphylococcus aureus 4 Kanavel Signs1. Flexed position of the finger2. Symmetric enlargement of the whole finger3. Excessive tenderness limited to the sheath4. Excruciating pain with passive finger extension Treatment- conservative only if very early diagnosis- surgery >48h after onset--> closed irrigation--> open drainage and debridement
- Herpetic Whitlow - viral infection caused by the autoinoculation of type I/II herpes simplex virus into broken skin - frequent in dental personnel, small children - small vesicles - abrupt onset of pain out of proportion to clinical finding Treatment: always conservative
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