UMEM Educational Pearls

Category: Orthopedics

Title: Management of Felons

Keywords: felon, management (PubMed Search)

Posted: 11/15/2014 by Michael Bond, MD (Updated: 7/18/2024)
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Management of Felons

  • An abscess of distal finger that involves the pulp. 
  • A difficult infection to treat due to the fibrous septa that divide the pulp into multiple small compartments. 
  • These septa run from the periosteum to the skin increasing the risk of osteomyelitis
  • Patients typically present with a lot of pain, redness, and swelling.
  • Typically triggered by a puncture wound (i.e.: splinter)
  • Incision and Drainage can result in a:
    • anesthetic finger tip
    • unstable finger pad
    • neuroma
  • If you are going to drain one it is recommended that you do a volar longitudinal incision down the middle of the finger pad or a high lateral incision. 
  • The high lateral incision should be at about 5 mm below the nail plate border. This distance is required to avoid the more volar neurovascular structures.

For good photos of the incision technique please visit the reference article listed.

 

References