수지 신전건의 외상성 화농성 건막염 후에 발생한 심한 관절면 파괴를 유발한 화농성 관절염의 치료

Abstract

Septic arthritis of metacarpophalangeal joint which were occurred after fight injury or penetration wound around the metacarpophalangeal joints is a disabling disease unless it is managed properly. And, sometimes the sacrifice of the affected finger may be required in severe cases to salvage the hand. The hand may retain little useful function if it is involved the thumb and index fingers. In cases of established ankylosis of finger joints and the surrounding soft tissues such as extensor and flexor tendons were necrotized, reconstruction of the joint could be attempted. From 1985 to 1998, we experienced four posttraumatic septic arthritis of metacarpophalangeal joint and reconstructed the joints using free joint transfer in two cases. The results were good and functional hands without residual infection were achieved. But, to prevent these tragedies of secondary joint transfer procedures, careful management of laceration wound around the metacarpophalangeal joints is mandatory. The optimal management should include not only antibiotic therapy but also early aggressive surgical management of the wound.