Infektiöse Arthritis der Fingergelenke

Angly, B.; Steiger, Regula; Zimmerli, Werner

doi:10.1055/s-2007-965137

Cited by 22 publications

(12 citation statements)

References 14 publications

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“…In this study, we were able to analyze a larger number of SJA episodes than have previously been reported [3, 4, 8–10]. We noted 3 considerable differences between septic arthritis of the larger joints (eg, hip or knee joint) described in the literature and our series of pyogenic SJA.…”

Section: Discussionmentioning

confidence: 74%

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Pyogenic Arthritis of the Fingers and the Wrist: Can We Shorten Antimicrobial Treatment Duration?

Meier¹,

Wirth²,

Hahn

et al. 2017

Open Forum Infectious Diseases

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Background.Pyogenic arthritis of the small joints of the hand and wrist is a known but poorly described entity. The objective of this work was to characterize the clinical presentation, antimicrobial treatment, and surgical interventions of native small joint arthritis (SJA) treated in our tertiary center.Methods.According to predefined variables, medical records of adult patients with SJA treated in a Swiss university hospital between 2005 and 2013 were retrospectively analyzed.Results.The median age of 97 patients (101 joints) was 52 years (interquartile range [IQR], 38–68 years); 52% had no comorbidity. Small joint arthritis of the second and third fingers accounted for 53% of infections, with metacarpal-phalangeal and proximal interphalangeal joints most commonly involved. Of 86 (89%) episodes with an exogenous source, 63 (65%) followed a trauma. The most commonly isolated microorganism was Staphylococcus aureus (38%), followed by β-hemolytic streptococci (13%) and Pasteurella spp (11%). Eighty-seven episodes (89 joints) in patients with follow-up examinations were included in treatment and outcome analyses. Up to 2 surgical interventions were required to cure infection in 74 (83%) joints. Median antimicrobial treatment duration was 14 days (IQR, 12–28 days), with amoxicillin/clavulanate administered in 74 (85%) episodes. At follow up, cure of infection was noted in all episodes and good functional outcome in 79% of episodes.Conclusions.Small joint arthritis shows considerable differences from clinical patterns reported for larger joints. In our series, the outcome was good with no more than 2 surgical interventions and median treatment duration of 14 days in 79% of episodes.

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Section: Discussionmentioning

confidence: 74%

“…The epidemiology of microorganisms causing SJA is not well established, because few studies have described it [3–5]. In addition, the optimal duration of antimicrobial therapy is yet to be elucidated [3, 4]. It is uncertain whether smaller and larger joints should be treated equally long.…”

mentioning

confidence: 99%

Pyogenic Arthritis of the Fingers and the Wrist: Can We Shorten Antimicrobial Treatment Duration?

Meier¹,

Wirth²,

Hahn

et al. 2017

Open Forum Infectious Diseases

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“…Operative Techniken Vorbemerkungen Weniger als 5% aller septischen Arthritiden betreffen die kleinen Fingergelenke [1,6,13]. Im Unterschied zur Infektion des Handgelenks stehen bei der Ätiolo-gie der septischen Fingergelenkinfektionen endogene Risikofaktoren wie Diabetes, Drogenabhängigkeit oder Immundefizienz im Hintergrund.…”

Section: Die Behandlung Bakterieller Infektionen An Den Interphalangeunclassified

“…Eine innere Fixation mit perkutan ausgeleiteten Dräh-ten oder permanenten Implantaten muss bei der Gelenkinfektion aufgrund des hohen Risikos einer Infektpersistenz vermieden werden [1]. Der Fixateur externe bietet gegenüber einer Ruhigstellung mit äu-ßerlich angelegten Schienen wesentliche Vorteile: Er erlaubt bei korrekter Anlage nicht nur eine effiziente Ruhigstellung des Gelenks, ohne den Zugang zur Wunde für Pflegemaßnahmen oder Lokalbehandlung (wie z.…”

Section: Die Behandlung Bakterieller Infektionen An Den Interphalangeunclassified

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Die Behandlung bakterieller Infektionen an den Interphalangealgelenken der Hand

Vorderwinkler

Mühldorfer

Pillukat

et al. 2011

Oper Orthop Traumatol

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In 10 of 40 patients, the infected joint could be preserved. All infections healed. After an average duration of therapy of 6 (3-11) weeks, 4 individuals were free of complaints, and 6 patients had minor symptoms. Overall range of motion in the affected finger was reduced by 25-50° in 5 patients. All patients could return to work after 6.6 (4-11) weeks. A total of 30 patients were treated with joint resection and external fixator. After 5.6 (4-8) weeks, arthrodesis was performed, leading to consolidation in 29 patients. One patient underwent amputation after 4 months due to delayed gangrene. Treatment duration was 15.7 (7-25) weeks. Eight patients reported no complaints, 14 suffered mild symptoms, 5 had moderate, and 3 had severe symptoms in daily life. In 15 cases, range of motion was diminished by 10-80° in the remaining joints of the affected finger. Patients could return to work after 16.2 (6-28) weeks.

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