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Surgery

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Suppurative flexor tendon tenosynovitis surgery has the aim of releasing pus to prevent adhesions. One effective way of doing this is:

  • the distal palmar crease is incised into in the affected digit
  • the proximal end of the flexor tendon sheath is identified
  • the sheath is divided longitudinally for a short distance, any fluid emanating should be cultured
  • a small bore nylon tube is passed down the sheath and secured proximally
  • at the distal flexor crease of the affected digit, a small lateral incision is made
  • the tendon sheath is carefully identified and incised to create an second, distal opening
  • normal saline is passed down the nylon tube and emerges out of the distal hole; this continues until the irrigation fluid is clear
  • at intervals, irrigation is continued for at least 2 days

Intravenous, the oral antibiotics are recommended for a week. Physiotherapy should commence as soon as possible after removal of the catheter.

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