Felon

Description:

Acute purulent inflammation of tissues of fingers.

Felon symptoms:

On the palmar surface of fingers skin connects to a palmar aponeurosis tendinous crossing points, creating at the same time channels. The infection on these channels quickly extends deep into, and hypostasis at an inflammation in a limited cavity (between tendinous crossing points) leads to increase in pressure, a prelum of the feeding vessels and necroses. At suspicion on infectious process on a brush expectation is inadmissible: early surgery with obligatory removal of necrotic fabrics is necessary. The indication to operation is the infection center which led the patient to sleepless night because of pains). The section has to pass through a point of the maximum pain.

Felon reasons:

Develops usually at hit of causative agents of a purulent infection in finger tissues at a microtrauma (pricks, grazes, cracks, etc.).

Treatment of the Felon:

Treatment in initial stages conservative: trays with potassium permanganate, antiseptic agents. At emergence of pus — operational treatment. Can be complicated by a hyponychial felon.

Hyponychial felon — accumulation of pus under a nail plate. Arises at suppuration of hyponychial hematomas, foreign bodys, transition of an inflammation from the periungual roller. There are expressed pain, "swimming" of a nail plate, Sometimes from under a nail plate pus is emitted.

Treatment operational — an onychectomy (partial or full).

Skin felon — accumulation of pus under epidermis in the form of a limited bubble. Arises at microtraumas or foreign bodys of skin more often. Under epidermis pus accumulation, a pain syndrome unsharp is defined. Removal of epidermis leads to recovery. After removal of epidermis it is necessary to examine carefully the abscess basis, the fistular course conducting in deeper departments of a finger at the bottom can open (the skin felon can be manifestation of a felon "in the form of a cuff link": the main center — a hypodermic felon).

Hypodermic felon — a frequent form of suppuration of fingers. The expressed pulling pain, local morbidity out of a projection of sinews are noted. More often process is localized on a nail phalanx: "The first sleepless night" serves as the indication to operation; the delay with operation threatens with transition of an inflammation to a bone or a joint.

The thecal whitlow — suppuration of a tendinous vagina is more often at distribution of a hypodermic felon deep into. Severe pain, sharp hypostasis of the affected finger which together with next is in a condition of palmar bending are noted. The palpation determines by the bellied probe of a projection of a sinew a zone of the maximum morbidity. The delay with operation leads to a necrosis of a sinew and loss of function of a finger, thecal whitlows of I and V fingers are especially dangerous — their tendinous vaginas are reported, at an inflammation there is U-shaped phlegmon of a brush with zateky on a forearm. The forecast is serious.

Joint felon — suppuration of a joint bag of an interphalangeal joint. More often is a complication of a hypodermic felon (later or incorrectly executed operative measure). The joint is sharply edematous, painful at a palpation, the pandiculation on an axis of a finger is sharply painful. Conservative treatment can be carried out only in the earliest stages (a joint puncture with washing of a cavity antibiotics). When strengthening pain and late stages — operational treatment. The forecast is serious.

The bone felon is more often localized on a nail phalanx. Are noted kolboobrazny swelling of a finger in a nail phalanx, morbidity at a palpation, bone crepitation sometimes is defined. Radiological bone sequestration is found. Treatment is operational.

Prevention of all types of felons — the prevention and timely correct treatment of injuries of a brush and fingers.