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 affected by pathology. Also, the disease is one of the neglected forms of panaritium.
Symptoms
The disease is quite severe, 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 crimson, sometimes blue, pus is released, the touch is extremely painful. The movement leads to acute pain, pain in the hands, swelling, and an increase in the size of the affected part of the body can occur.
Disease Education Statistics
Osteoarticular pandactylitis is the most common form of panaritium, in the percentage of this pathology accounts for about 44% of cases, followed by bone pandactylitis - 35%, followed by tendon - 20% of patients. It is always necessary to take into account the causal relationships that preceded the development of complications.
Causes of Pandactylitis
The most common causes of the development 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, joint, bone complications of the disease, which can occur as a result of an unsuccessful operation.
Having identified and examined the possible causes of the disease, it is possible to draw the necessary conclusions about the nature of the occurrence and the rate of spread of pandactylitis and prescribe the appropriate therapy. Circulatory disturbance, tissue breakdown, lack of oxygen in the tissues - this is what precedes the development of finger pandactylitis. When soft tissue is damaged, 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 treatment methods. It is extremely undesirable to open purulent bags, this can lead to the spread of infection to healthy areas of the dermis. One of the unpleasant manifestations of pandactylitis disease is the spread of infection to the nail plate, as this results in a detachment of the nail. A new nail, which will form in the future, often grows already deformed.
Tendon, articular, subcutaneous, bone pandactylitis is an inflammation that threatens to develop a strong purulent process and an acute abscess of the hands, forearm, and in advanced cases, there may be a violation of the motor function of the hand, ankylosis, and much more.
Diagnostics
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 purulent inflammation and must be distinguished from gout, tuberculosis, gonorrhea, rheumatism, arthritis and so on. X-ray examination will help to help identify articular and bone panaritium in modern diagnostics. The proper prevention of the disease is 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. Fixation of the hand or forearm is necessary to prevent mobility. The use of heat is useful: warming compresses, warm baths, UHF, and more.
In the early stages of articular or tendon pandactylitis, a joint cavity is punctured and purulent contents are pumped out, and then antibiotics are administered. A puncture is done in the area of the main phalanx, and the drugs are injected under the roller, lifting it with a scalpel. Under it lay a thin strip of gauze soaked in antibiotics. Conservative local treatment lasts about 3 days, in the absence of a result, resort to urgent surgical intervention.
Surgery for pandactylitis involves the complete removal of the epidermis, the procedure cannot be performed without painkillers. First, pus is removed, then a special dressing soaked in table salt follows. In the absence of complications, dressings with ointment are used. When the disease spreads on the nail, an incision in the form of an oval or semi-oval is used. In the wound put drainage from a rubber tube or gauze, sometimes antibiotics are administered. In the case of a bone form of pandactylitis, the source of pus is opened, the wound is drained.
With articular pandactylitis, dissection is carried out in the form of two parallel sections, then the joint is thoroughly washed, and drainage is established. Sometimes there is a destruction of the articular surface of the bone, in this case there is a complete removal of the affected part.
Tendon pandactylitis, as a rule, should only be treated surgically. Two parallel front incisions are made in the area 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 is cut near the base of the finger, then drainage is established.
In surgery, the pandactylitis code according to ICD-10 is L03.0.