Pandactylitis is a disease that manifests itself as a purulent lesion of the soft and hard tissues of the fingers. Skin, tendons, bones, formations between the phalanges - all this is exposed to the action of pathology. Also, the disease is one of the advanced forms of panaritium.
Symptoms
The disease is quite difficult, because it is accompanied by obvious intoxication: body temperature rises, headaches are present, lymph nodes increase. In the blood there are indicators indicating acute purulent inflammation. The development of the disease occurs gradually, at first the pains are mild, but over time they cause suffering and become intense. The finger becomes dark purple, sometimes blue, pus is released, the touch is extremely painful. Movement leads to acute pain, pain in the hands, swelling, and an increase in the size of the affected part of the body.
Disease formation statistics
Osteoarticular pandactylitis - the most common form of panaritium, in percentage terms for thispathology accounts for about 44% of cases, followed by bone pandactylitis - 35%, then tendon - 20% of patients. It is always necessary to take into account the causal relationships that preceded the development of the complication.
Causes of pandactylitis
The most common causes of the disease are:
- improper treatment of an open wound,
- ineffective treatment of panaritium during infiltration,
- Mistakes made in the surgical intervention of subcutaneous pandactylitis,
- tendon, articular, bone complications of the disease, which may occur as a result of an unsuccessful operation.
Having identified and considered the possible causes of the disease, it is possible to draw the necessary conclusions about the nature of the occurrence and rate of spread of pandactylitis and prescribe appropriate therapy. Circulatory disorders, tissue breakdown, lack of oxygen in the tissues - this is what precedes the development of finger pandactylitis. When soft tissue is affected, the infection begins to develop and spread extremely quickly.
Possible Complications
Regardless of the form of the disease, sepsis, lymphadenitis, lymphangitis can develop. Pandactylitis, which has formed near the nail or on the skin, has limitations in the methods of therapy. It is highly undesirable to open purulent bags, this can lead to the spread of infection to he althy areas of the dermis. One of the unpleasant manifestations of the pandactylitis disease is the spread of infection to the nail plate, since as a result of thisdetachment of the nail occurs. A new nail that forms in the future often grows already deformed.
Tendon, articular, subcutaneous, bone pandactylitis is an inflammation that threatens with the development of a strong purulent process and an acute abscess of the hand, forearm, and in advanced cases, there may be a violation of the motor function of the hand, ankylosis and much more.
Diagnosis
There are no difficulties in recognizing the disease. An important aspect is the diagnosis of the disease and further complications at an early stage in the development of pathology. Pandactylitis is a purulent inflammation and must be distinguished from gout, tuberculosis, gonorrhea, rheumatism, arthritis, and so on. X-ray examination will help to recognize articular and bone panaritium in modern diagnostics. Proper prevention of the disease is considered to be hand hygiene, timely treatment of open wounds, prevention and treatment of injuries.
Treatment
At the very beginning of the development of the disease, conservative treatment is used, such as intramuscular injections of antibiotic drugs with novocaine. It is necessary to fix the hand or forearm to prevent mobility. Useful heat applications: warm compresses, warm baths, UHF, and more.
In the early stages of articular or tendon pandactylitis, a joint cavity is punctured and the purulent contents are pumped out, and then antibiotics are administered. A puncture is made in the zone of the main phalanx, and the drugs are injected under the roller,lifting it up with a scalpel. Under it lay a thin strip of gauze soaked in antibiotics. Conservative local treatment lasts about 3 days, if there is no result, they resort to urgent surgical intervention.
Surgery for pandactylitis involves the complete removal of the epidermis, the procedure cannot be performed without painkillers. First, the pus is removed, followed by the application of a special dressing soaked in table s alt. In the absence of complications, dressings with ointment are used. With the spread of the disease on the nail, an incision in the form of an oval or semi-oval is used. Drainage is placed in the wound from a rubber tube or gauze, sometimes antibiotics are administered. In the case of the bone form of pandactylitis, the source of pus is opened, the wound is drained.
In case of articular pandactylitis, a dissection is carried out in the form of two parallel incisions, then the joint is thoroughly washed, drainage is established. Sometimes there is a destruction of the articular surface of the bone, in this case, the complete removal of the affected part occurs.
Tendonous pandactylitis should generally only be treated with surgery. Two parallel anterior incisions are made in the zone of the main phalanx and an additional incision in the palm to open the blind sac. If the process went to the back surface of the hand and touches the elbow bag, then the back area of the bone surface near the base of the finger is cut, then drainage is installed.
In surgery, ICD-10 pandactylitis code L03.0.
