Infections of the Hand, injection injuries-Case: Infection of the Hand

Case: Infection of the Hand

Pdf Summary

Pt. AA, a 44-year-old female, presents with increasing pain in her hand for the past three days. She recently had an altercation with someone but denies having fevers or chills. She has a history of diabetes and intravenous drug abuse and was recently released from prison. Radiographs do not show any foreign body or fracture, but her white blood cell count is elevated at 13.7 and her temperature is 101.2°F. <br /><br />The plan for Pt. AA involves starting intravenous antibiotics to cover both gram-positive, including MRSA, and gram-negative organisms due to her risk factors. Given the tissue necrosis across the dorsum of her hand, surgical debridement is necessary. Cultures will be obtained to guide postoperative antibiotic therapy. A examination of the extensor digitorum communis and juncturae tendinae will also be conducted. <br /><br />During the surgery, a sagittal band incision will be made over the long and ring finger. MCP capsulotomy and joint washout will then be performed. The sagittal band will be reapproximated, but the soft tissue will be left open to heal by secondary intention. Soaks and dressing changes will be done, and a splint will be used for four days. Early range of motion exercises will be initiated to prevent stiffness in the hand.

Keywords

hand pain

fever

diabetes

drug abuse

radiographs

white blood cell count

surgical debridement

cultures

soft tissue

range of motion exercises