Bone and joint infections of the hand.

Sendi P; Kaempfen A; Uçkay I; Meier R

doi:10.1016/j.cmi.2019.12.007

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Journal article

Bone and joint infections of the hand.

Sendi P Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Switzerland; Department of Orthopaedics and Traumatology, University Hospital Basel, University of Basel, Switzerland; Institute of Infectious Diseases, University of Bern, Bern, Switzerland. Electronic address: parham.sendi@ifik.unibe.ch.
Kaempfen A Clinic for Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Switzerland.
Uçkay I Infectiology, Balgrist University Hospital, Zürich, Switzerland.
Meier R Department of Plastic and Hand Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

2020-01-10

Published in:

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. - 2020

English BACKGROUND
Little guidance is currently available for standardized diagnostic protocols and therapeutic recommendations for bone and joint infections (BJIs) of the hand.

OBJECTIVES
To summarize the available data in the scientific English-language literature on the diagnosis and treatment of native BJIs of the hand. To illustrate these concepts from a narrative point of view in areas where there is lack of evidence.

SOURCES
We performed a systematic PubMed and Internet search of studies that investigated hand BJIs in adult patients.

CONTENT
Few studies have systematically investigated and validated diagnostic concepts, classifications or surgical treatment protocols. Most concepts derive from traditional intra-institutional experience, expert opinions and extrapolations from infections in large joints and long bones. Similarly, there is no uniformly accepted infection definition of BJIs of the hand. The best-documented literature is available for microbiological findings and antibiotic treatment duration in uncomplicated native joint arthritis of the fingers. Retrospective studies and one prospective randomized trial suggest that post-surgical targeted antibiotic therapy of 2 weeks results in a microbiological cure rate of ≥88%.

IMPLICATIONS
Studies on diagnostic workup and infection definition and classification are urgently needed to compare inter-institutional outcome results and generate guidelines for the best patient care. For uncomplicated pyogenic arthritis of native joints, current evidence suggests that a 2-week course of antibiotic therapy following surgery cures the infection.

Language