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General Orthopaedics

A RETROSPECTIVE REVIEW OF FLEXOR SHEATH INFECTIONS AT THE PULVERTAFT HAND UNIT

The New Zealand Orthopaedic Association (NZOA) Annual Scientific Meeting 2023, Nelson, New Zealand, 5–7 November 2023.



Abstract

Introduction

Flexor sheath infections require prompt diagnosis, and management with intravenous antibiotics and/or surgical washout followed by physiotherapy. Complication rates as high as 38% have been reported.

Methods

A retrospective review was carried out of all patients between January 2014 and May 2021 attending with a suspected or confirmed diagnosis of flexor sheath infection. Age, gender, co-morbidities, cause of infection, management, and subsequent complications recorded.

Results

Of 132 patients, 67% were male. Mean age was 50.8 years. A trend towards fewer presentations each year with animal bites, foreign bodies and penetrating trauma as the main cause of infection. 89% (n=117) required admission, 77% (n=101) underwent a surgical washout. 11% (n=15) were treated as an outpatient. 7% (n=9) suffered a complication.

Discussion

Whilst flexor sheath washout continues to be the treatment of choice, 23% of patients were managed with intravenous antibiotics, 48% of these purely via an outpatient service. Our overall complication rate was 7%.