A 36-year-old carpenter has a puncture wound to the finger. The finger is held flexed, is diffusely swollen and exquisitely tender along the flexor

Question

A 36-year-old carpenter has a puncture wound to the finger. The finger is held flexed, is diffusely swollen and exquisitely tender along the flexor sheath, with pain on passive extension. He is afebrile and neurovascularly intact. What is the most appropriate initial management?

Accepted Answer

Give IV antibiotics, immobilise and consult hand surgery urgently

Answer

Perform bedside incision and drainage through the palm without consultation

Answer

Inject corticosteroid into the tendon sheath

Answer

Arrange elective physiotherapy without antibiotics

Answer

Discharge with topical antibiotic ointment

Pyogenic flexor tenosynovitis — RCPSC EM MCQ

A 36-year-old carpenter has a puncture wound to the finger. The finger is held flexed, is diffusely swollen and exquisitely tender along the flexor sheath, with pain on passive extension. He is afebrile and neurovascularly intact. What is the most appropriate initial management?