Abstract

FIRPO, Carlos A. N.; MIRANDA, Miguel  and  FRANZOSI, Nicolás. Tuberculosis of the hand and wrist. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2010, vol.75, n.3, pp.231-235. ISSN 1852-7434.

Background: The incidence of tuberculosis has been increasing steadily. The extra pulmonary disease could be located in the spine, knee and hip. In the hand and wrist it is infrequent. Tendons, joints and bones are affected. We intend to analyze the pathology and treatment and emphasize our simultaneous reconstructive procedures in the long term. Methods: We treated a total of 19 patients in 45 years. 3 were spina ventosa or tuberculous dactylitis, 10 flexor tendon tenosynovitis, 4 extensor tendon tenosynovitis and 2 wrist arthritis. We used modern diagnostic procedures, modern treatment, and the original simultaneous reconstructive technique. The outcomes were presented retrospectively. Results: All patients should be treated with surgical debridement and chemotherapy. If the treatment had been strictly followed, 99% success could be expected. There was no recurrence of the disease. The final functional outcome was directly related to the extent and severity of the damage. Conclusions: Meat processing workers and farmers are very prone to the disease. We confirm the importance of the advances in modern diagnostic methods. The outcome was excellent after debridement, ruptured tendons reconstruction and patient management with six to eighteen months of antituberculous drugs.

Keywords : Tenosynovitis; Tendons reconstructive surgery; Tuberculous dactylitis; Tuberculous arthritis.

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