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Handchir Mikrochir Plast Chir 2021; 53(03): 267-275
DOI: 10.1055/a-1472-1689
Übersichtsarbeit

Infektionen der Beugesehnenscheide

Pyogenic Flexor Tenosynovitis
Martin Franz Langer
1   Universitätsklinikum Münster; Klinik für Unfall-, Handund Wiederherstellungschirurgie
,
Jörg G. Grünert
2   Kantonsspital St. Gallen, Schweiz
,
Frank Unglaub
3   Vulpiusklinik, Bad Rappenau
,
Johanna Ueberberg
1   Universitätsklinikum Münster; Klinik für Unfall-, Handund Wiederherstellungschirurgie
,
Johannes Glasbrenner
1   Universitätsklinikum Münster; Klinik für Unfall-, Handund Wiederherstellungschirurgie
,
Simon Oeckenpöhler
1   Universitätsklinikum Münster; Klinik für Unfall-, Handund Wiederherstellungschirurgie
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Zusammenfassung

Die Infektionen der Beugesehnenscheide gehören immer noch zu den gravierendsten und folgenschwersten Infektionen an der Hand. Wenn die typischen Kardinalzeichen einer Beugesehnenscheideninfektion nach Kanavel bestehen, sollte unverzüglich die Indikation zur Operation gestellt werden. Die Folgeschäden einer verzögerten oder verspäteten Operation mit enormen Bewegungseinschränkungen der Finger durch Zerstörung der Gleitschichten und massiven Verklebungen, die sich später häufig nur noch wenig durch Handtherapie verbessern lassen, sind so gravierend, dass sich konservative Therapieversuche nur sehr schwer rechtfertigen lassen. Das schnelle chirurgische Eingreifen und die frühzeitige Eröffnung und Entlastung sowie die Spülung der Sehnenscheide kann die Erkrankung, die Zerstörung der Gleitschichten sowie die starken Schmerzen fast augenblicklich beenden. Wichtig sind ein schnelles Erkennen und ein schnelles Handeln. Bei frühzeitiger Intervention kann häufig die normale Handfunktion komplett wiederhergestellt werden.

Summery

Pyogenic flexor tenosynovitis (PFT) is still the most serious infections of the hand. If the typical cardinal signs of PFT according to Kanavel exist, the indication for surgery should be made immediately. The consequential damage of a delayed surgery with enormous restrictions on the movement of the fingers due to the destruction of the sliding layers and massive adhesions are so serious that conservative therapy attempts are very difficult to justify. The results of Hand therapy after delayed surgery are often disappointing. The rapid surgical intervention and the early opening and relief as well as the irrigation of the tendon sheath can end the disease, the destruction of the sliding layers and the severe pain almost immediately. Quick recognition and quick action are important. With early intervention, normal hand function can often be completely restored.

Schlüsselwörter

Eitrige Sehnenscheidenentzündung - Stadieneinteilung - Kanavel-Kardinalzeichen - Diagnose - Therapie

Key words

Pyogenic flexor tenosynovitis - classification - Kanavelʼs signs - diagnosis - therapy


Publication History

Received: 15 March 2021

Accepted: 16 March 2021

Article published online:
16 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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