Chronic Post-traumatic Inflammatory Tenosynovitis of the Finger Joint

Heo,  Youn Moo; Kim,  Sang Bum; Roh,  Jae Young; Park,  Won Ki; Oh,  Hyung Tak; Yi,  Jin Woong

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Journal of the Korean Society for Surgery of the Hand 2010;15(1):8-14.
Published online March 1, 2010.

Chronic Post-traumatic Inflammatory Tenosynovitis of the Finger Joint

Youn Moo Heo, Sang Bum Kim, Jae Young Roh, Won Ki Park, Hyung Tak Oh, Jin Woong Yi

Department of Orthopedic Surgery, Konyang University College of Medicine, Daejeon, Korea. oeo-oeoeo@hanmail.net

Abstract

Purpose
Chronic inflammatory tenosynovitis (CITS) involving the finger joint after trauma has been rarely reported. This study reports the surgical results of ten patients with CITS. MATERIALS AND METHODS: From March 2007 to June 2009, ten patients with pain, swelling and limitation of motion of the finger were diagnosed as CITS. All patients had a history of direct injury. The operation was performed at a mean of 6.6 months after the onset of symptom. Average range of motion was 54 degrees in five patients with CITS of the metacarpophalangeal joint and was 44 degrees in five patients with that of the proximal interphalangeal joint. The mean follow-up duration was 15 months. Two of ten patints showed the involvement of the bone. Tenosynovectomy was performed and four patients required volar and dorsal double incisions. In cases of the bony invasion, multiple drilling and curettage was done.

Results
Postoperatively, all patients showed improvement of pain and swelling and did not show recurrence. The magnetic resonance image was carried out in all patients and showed the inflammatory changes of the tendosynovium and joint capsule. Culture and PCR test for tuberculosis showed negative findings in all cases. However, anti-tuberculosis chemotheraphy for nine months was applied to three patients who showed caseous necrosis or rice body in biopsy. The mean range of motion was 66 degrees in metacarpophalangeal joint and 53 degrees in proximal interphalangeal joint.

Conclusions
Magnetic resonance image appears helpful in the diagnosis and the treatment of CITS which involved the joint of hand and the operative treatment can improve the symptoms and clinical outcomes.

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