術後持続灌流に間欠的局所麻酔剤注入を併用した化膿性屈筋腱腱鞘炎の1例

Intermittent Injection of Local Anesthetics Combined with Continuous Perfusion for Pyogenic Flexor Tenosynovitis. Case Report

　右中指に発生した化膿性屈筋腱腱鞘炎に対して，デブリドマン後の持続灌流に間欠的局所麻酔剤注入を併用し，良好な治療成績を得た．症例は53歳の男性で，ガラスで右中指MP関節掌側基部を切り受傷した．受傷後3日目で当科を初診し同日デブリドマンを行った．術後持続灌流に間欠的局所麻酔剤注入を併用し，疼痛と局所の感染兆候は著明に改善した．術後4日目から自動可動域訓練を開始し，術後1.5カ月で仕事に復帰した．術後5カ月で疼痛はなく，Flynnの機能評価ではGoodであった．

　We report a case of pyogenic flexor tenosynovitis successfully treated by a combination of intermittent local anesthetic injection and continuous antibiotic perfusion developed by the authors.　A 53-year-old man who had injured the base of his middle finger came to our clinic three days later and was diagnosed with pyogenic flexor tenosynovitis.　Debridement was performed on the same day, and above-described combined treatment was started.　Two days later the local pain and signs of infection had decreased, and four days after surgery it was possible to start active range of motion.　Six weeks after surgery the patient was able to return to the same job.　Five months after surgery the patient had no pain or disability, and good results had been obtained according to Flynn's evaluation.