Osteomyelitis of the tubular bones of the hand

K. E. Reilly, J. C. Linz, P. J. Stern, Eric Giza, J. D. Wyrick

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

The records of 700 patients with hand infections were reviewed. Forty- six (6%) had osteomyelitis of the metacarpals or phalangeal bones. The cause was post-traumatic in 57%, postoperative in 15%, hematogenous in 13%, spread from contiguous infections in 9%, and unidentified in 6%. Twenty-two percent of the patients had vascular insufficiency and/or were immunocompromised. History, physical exam, plain x-rays, and open biopsy and culture were most helpful in establishing the diagnosis. Laboratory studies and bone scans were less helpful. Cultures were positive in 74% of patients, with a noteworthy number of mixed infections (35%) and gram-positive infections (35%). Gram- negative infections accounted for 15%, fungal infections for 12%, and mycobacterial infections for 3%. Surgical management varied from simple curettage to more elaborate staged reconstructions and/or arthrodeses. Despite provision of aggressive surgical care and use of appropriate antibiotics, the overall amputation rate was 39% (18/46). A delay of more than 6 months from onset of symptoms to diagnosis and definitive treatment led to amputation in 6 of 7 patients (86%), 2 of whom had squamous-cell carcinoma. Of the 12 patients who underwent more than 3 surgical procedures, 8 ultimately underwent amputation and 2 had marked disability.

Original languageEnglish (US)
Pages (from-to)644-649
Number of pages6
JournalJournal of Hand Surgery
Volume22
Issue number4
DOIs
StatePublished - 1997
Externally publishedYes

Fingerprint

Hand Bones
Osteomyelitis
Amputation
Infection
Bone and Bones
Metacarpal Bones
Curettage
Mycoses
Arthrodesis
Coinfection
Blood Vessels
Squamous Cell Carcinoma
Hand
History
X-Rays
Anti-Bacterial Agents
Biopsy

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Reilly, K. E., Linz, J. C., Stern, P. J., Giza, E., & Wyrick, J. D. (1997). Osteomyelitis of the tubular bones of the hand. Journal of Hand Surgery, 22(4), 644-649. https://doi.org/10.1016/S0363-5023(97)80122-0

Osteomyelitis of the tubular bones of the hand. / Reilly, K. E.; Linz, J. C.; Stern, P. J.; Giza, Eric; Wyrick, J. D.

In: Journal of Hand Surgery, Vol. 22, No. 4, 1997, p. 644-649.

Research output: Contribution to journalArticle

Reilly, KE, Linz, JC, Stern, PJ, Giza, E & Wyrick, JD 1997, 'Osteomyelitis of the tubular bones of the hand', Journal of Hand Surgery, vol. 22, no. 4, pp. 644-649. https://doi.org/10.1016/S0363-5023(97)80122-0
Reilly, K. E. ; Linz, J. C. ; Stern, P. J. ; Giza, Eric ; Wyrick, J. D. / Osteomyelitis of the tubular bones of the hand. In: Journal of Hand Surgery. 1997 ; Vol. 22, No. 4. pp. 644-649.
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