Infections of the flexor tendon sheath are rare. We report on 49 patients who were treated in a five-year period from 1996 to 2000. The follow-up period was 45 months on average. We used an extensive skin incision for revision and regularly placed gentamycin-PMMA-chains in the wound. All patients were treated as inpatients. We achieved good and excellent results in 85% of patients.

Because of the capability of opposition, the thumb is the most important digit of the hand. In case of deep soft-tissue defects of the pulp, it is necessary to reconstruct the palmar surface of the distal phalanx of the thumb using tissue with good sensibility. Between 1982 and 1998 at the Department of Hand Surgery, Plastic and Microsurgery of the Berufsgenossenschaftliche Unfallkrankenhaus Hamburg, we used a free toe pulp neurovascular flap for reconstruction of the pulp of the thumb in nine patients. All flaps healed without complications. Indications, operative techniques, and results of this procedure are described.