[Septic arthritis of finger joints]

Abstract

Background and purpose: Septic arthritis of finger joints is rare and its management not standardized. The outcome of all consecutive patients with finger joint arthritis was analyzed in terms of risk factors, surgical technique, antimicrobial therapy and hand therapy.

Patients and methods: Data of 31 patients with surgical treatment between 1993 and 2005 were screened and those from 29 patients with > 1 year of follow-up were retrospectively analyzed. Surgical techniques were debridement, primary, secondary arthrodesis or temporary joint distraction with external fixation. In addition, all patients were treated with antibiotics and hand physiotherapy. The median follow-up of the 29 patients was 5.7 years.

Results: The most frequent cause was work injury (19/29), the leading causing agent Staphylococcus aureus (9/29). Overall 16/29 (55 %) of the patients with follow-up had a good result regarding healing of infection, lack of pain and fair function. Primary arthrodesis was performed in 3, secondary arthrodesis in 4 patients. 3 patients were treated with temporary external fixation for three weeks. Cartilage damage detected during surgery (p = 0.01) was the significant risk factor for a bad outcome. The median delay to treatment was 4 days (1 - 550 days). Antibiotics were given for a median of 2 days by the iv-route and 17 days orally.

Conclusions: Septic arthritis of finger joints should be early recognized and immediately treated with surgery and antibiotics, in order to avoid cartilage damage. If cartilage is already damaged, primary arthrodesis with the use of an external fixation is indicated.