Flexor tendon sheath infection

Question 1

What is a flexor tendon sheath infection?

Answer 1

This is an infection within the flexor tendon sheath, which tracks up the palm and hand

Question 2

What are some possible causes of flexor tendon sheath infection?

Answer 2

This can occur from direct penetrating trauma such as a knife wound or via haematogenous spread (e.g. dental infection)

Question 3

How will flexor tendon sheath infection usually present?

Answer 3

Extremely painful fingers and palm with limited extension, including passive

Question 4

What are the Kanavel’s cardinal signs of flexor tendon sheath infection?

Answer 4

• Affected finger held in fixed position
• Fusiform swelling over finger
• Painful to percuss over sheath
• Painful on passive extension

Question 5

How should flexor tendon sheath infection be managed?

Answer 5

This is a surgical emergency!

Management is an urgent wash out of the tendon sheath, with opening up of the A1 and A5 pulleys