scholarly journals Development of a Murine Model of Pyogenic Flexor Tenosynovitis

2020 ◽  
Author(s):  
Bowen Qiu ◽  
Justin Cobb ◽  
Alayna Loiselle ◽  
Constantinos Ketonis
Keyword(s):  
Murine Model ◽  
Tendon Sheath ◽  
Cellular Infiltrate ◽  
Cellular Mechanisms ◽  
Multiple Comparison Test ◽  
Hematoxylin Staining ◽  
Flexor Tendon Sheath ◽  
Pyogenic Flexor Tenosynovitis ◽  
Novel Therapeutic Strategies ◽  
Flexor Tenosynovitis

ABSTRACTBackgroundTo demonstrate the plausibility of a murine model of pyogenic flexor tenosynovitis.Methods2μL of sterile PBS or bioluminescent Xen29 Staphylococcus aureus was administered to the tendon sheath of 36 male C57BL/6J mice. The infectious course was monitored by bioluminescence (BLI) signal via IVIS imaging and recording of weight change. The infected hind paws were harvested at four time points: 24 hours, 72 hours, 1 week and 2 weeks for histopathology using Alcian Blue hematoxylin staining. Two-way ANOVA with Sidak’s multiple comparison test was used for statistical analysis.ResultsThe infected cohort displayed significantly elevated bioluminescent values, reductions in weight, and exhibited swelling of the infected digit throughout the course of infection. By day 7 most infected mice saw a substantial decrease in BLI signal intensity, however two infected mice exhibited persistent BLI intensity through day 14. Histopathology of the infected cohort showed tissue disorganization and the presence of a cellular infiltrate in and around the flexor tendon sheath.ConclusionsA murine model of pyogenic flexor tenosynovitis is possible. Further optimization of the model offers an experimental platform for investigation of the pathophysiology of pyogenic flexor tenosynovitis.Clinical RelevanceThis animal model can be utilized in order to elucidate the basic molecular/cellular mechanisms of pyogenic flexor tenosynovitis while simultaneously evaluating novel therapeutic strategies.

Treatment of Pyogenic Flexor Tenosynovitis in the Emergency Department Setting With WALANT Technique

Hand ◽  
2021 ◽  
pp. 155894472110306
Author(s):  
Matthew E. Braza ◽  
Joshua P. Kelley ◽  
John P. Kelpin ◽  
Matthew P. Fahrenkopf ◽  
Viet H. Do
Keyword(s):  
Emergency Department ◽  
Local Anesthesia ◽  
Flexor Tendon ◽  
Perioperative Complications ◽  
Hand Surgery ◽  
Tendon Sheath ◽  
Emergency Department Setting ◽  
Flexor Tendon Sheath ◽  
Pyogenic Flexor Tenosynovitis ◽  
Flexor Tenosynovitis

Background The standard of care for treatment of pyogenic flexor tenosynovitis (PFT) involves antibiotic therapy and prompt irrigation of the flexor tendon sheath, traditionally performed in the operating room. With the acceptance of wide-awake local anesthesia no tourniquet (WALANT) hand surgery and its potential ability to minimize time to flexor tendon sheath irrigation, we sought to determine whether closed irrigation of the flexor tendon sheath could be safely and effectively performed in the emergency department setting with WALANT technique. Methods A retrospective review was conducted of the senior author’s hand surgery consultations over a 12-month period. Six patients were identified who were diagnosed with PFT and subsequently underwent irrigation of the flexor tendon sheath using WALANT technique. Patient outcomes such as length of hospital stay, need for reoperation, infectious etiology, perioperative complications, and postprocedure range of motion (ROM) were identified. Results Six patients with diagnosis of PFT underwent irrigation of the flexor tendon sheath in the emergency department with local anesthesia only. The irrigation procedures were all well-tolerated. One patient required reoperation due to lack of appropriate clinical improvement following initial irrigation. Four of 6 patients regained their preinjury ROM while the remaining 2 patients had mild proximal interphalangeal joint extension lag. There were no complications associated with the procedures. Conclusions Surgical treatment of PFT with closed irrigation of the flexor tendon sheath in the emergency department utilizing WALANT technique was safe, effective, and well-tolerated. Local anesthesia alone can be used effectively for irrigation procedures of the flexor tendon sheath.

Passage of an Irrigation Catheter with the Aid of a Guide Wire for Pyogenic Flexor Tenosynovitis

1997 ◽  
Vol 22 (4) ◽  
pp. 548-549 ◽  
Author(s):  
E. D. HOFFMAN ◽  
S. S. DESAI ◽  
L. S. LEVIN
Keyword(s):  
Guide Wire ◽  
Tendon Sheath ◽  
Feeding Tube ◽  
Pyogenic Flexor Tenosynovitis ◽  
Flexor Tenosynovitis

Typically an irrigation catheter or feeding tube is passed within the tendon sheath for treatment of pyogenic flexor tenosynovitis. We describe the use of a guide wire to facilitate the passage of the flexible irrigation device into the narrow sheath. The materials described are standard and readily available.

scholarly journals Development of a Murine Model of Pyogenic Flexor Tenosynovitis

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Bowen Qiu ◽  
Justin Cobb ◽  
Alayna E. Loiselle ◽  
Constantinos Ketonis
Keyword(s):  
Murine Model ◽  
Pyogenic Flexor Tenosynovitis ◽  
Flexor Tenosynovitis

Epithelial inclusion cyst of the equine digital flexor tendon sheath: diagnosis by ultrasonography and magnetic resonance and successful treatment by tenoscopy

2019 ◽  
Vol 88 (6) ◽  
pp. 320-326 ◽  
Author(s):  
Z. Joostens ◽  
L. Vanslambrouck ◽  
H. De Cock ◽  
T. Mariën
Keyword(s):  
Magnetic Resonance ◽  
Flexor Tendon ◽  
Surgical Excision ◽  
Tendon Sheath ◽  
Good Prognosis ◽  
Inclusion Cyst ◽  
Flexor Tendon Sheath ◽  
Dense Mass ◽  
Epithelial Inclusion Cyst ◽  
Distal Aspect

A six-year-old warmblood horse was presented with a longstanding frontlimb lameness with mild digital flexor tenosynovitis and swelling of the distomedial pastern. Ultrasonography and magnetic resonance revealed a dense mass lesion in the distal aspect of the digital flexor tendon sheath, with a partial lamellar architecture, absence of internal vascularization and adjacent smooth pressure osteolysis of the middle phalanx. After surgical excision, histopathology confirmed an epithelial inclusion cyst. Epithelial inclusion cysts, also known as keratinizing or follicular cysts, are expansile benign mass-like lesions of aberrant epidermal tissue. In the horse, they are known to occur in cutaneous and several non-cutaneous tissues. In the digital flexor tendon sheath, they have rarely been described. Given their often chronic presentation in this location, they may appear as an atypical dense mass on imaging, uncommon for cystic lesions. Complete tenoscopic removal, even for larger masses, is achievable and considered curative with good prognosis for return.

PYOGENIC FLEXOR TENOSYNOVITIS

Hand Clinics ◽  
1998 ◽  
Vol 14 (4) ◽  
pp. 567-578
Author(s):  
S. David Boles ◽  
Christopher C. Schmidt
Keyword(s):  
Pyogenic Flexor Tenosynovitis ◽  
Flexor Tenosynovitis

Transthecal Digital Nerve Block

1998 ◽  
Vol 23 (4) ◽  
pp. 490-493 ◽  
Author(s):  
N. S. SARHADI ◽  
J. SHAW-DUNN
Keyword(s):  
Methylene Blue ◽  
Nerve Block ◽  
Flexor Tendon ◽  
Proximal Phalanx ◽  
Proximal Part ◽  
Tendon Sheath ◽  
Areolar Tissue ◽  
Digital Nerve ◽  
Flexor Tendon Sheath ◽  
Digital Nerve Block

Injection studies using methylene blue and latex were used in 60 digits from 40 cadavers to study how anaesthetic fluid injected into the flexor tendon sheath might spread around the proximal part of the finger. The injected solution escaped from the flexor tendon sheath around the vincular vessels which are present near the base and head of the proximal phalanx. Outside the digital canal, the dye flowed smoothly through the perivascular loose areolar tissue and spread alongside the main digital vessels and nerves and their palmar and dorsal branches.

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