Felon

Felon describes infection within the longitudinal fibrofatty compartments which divide up the pulp at the tip of a digit. Usually, infection is acquired through a penetrating wound. It accounts for around 10% of hand infections.

Pain, swelling and erythema of rapid onset are noted in the distal phalanx region. The danger is that infection will extend more deeply into bone or proximally into the flexor tendon sheath.

Mangement entails:

• rapid incision in the longitudinal, mid-lateral line of the digit avoid incisions at the tip of the finger
• pus should be taken for culture
• the wound is packed and a protective dressing applied
• irrigation and regular repacking prevent recurrence
• oral antibiotics should be commenced; severe infections may require the intravenous route