Bone and joint infections of the hand

Septic arthritis of hand joints is generally caused by exogenous inoculation from local trauma (eg cuts, bites, clenched-fist injuries). Haematogenous seeding is rare and involves the wrist more often than finger joints. A multidisciplinary approach is often required for prompt diagnosis and surgical intervention. For uncomplicated septic arthritis of the hand with adequate surgical source control, 14 days of therapy (intravenous + oral) is usually sufficientSendi, 2020.

Osteomyelitis of the fingers and of the wrist may also occur from local trauma (eg open fractures, wound contamination, surgery). Haematogenous seeding may occur and is more frequent in children than in adults. A multidisciplinary approach is also often required for prompt diagnosis and surgical intervention, where indicated. For osteomyelitis involving the metacarpals or phalanges, the treatment duration is less clear than for septic arthritis. However, a shorter duration of therapy than what is required for long-bone osteomyelitis may be sufficientSendi, 2020.

For adults and children with bone and joint infections of the hand resulting from traumatic wounds or bite and clenched-fist injuries, see Empirical therapy for bite and clenched-fist injury infections associated with systemic features or deeper tissues.

For adults and children with bone and joint infections of the hand in the absence of a traumatic wound, see Long-bone osteomyelitis in adults, Empirical therapy for osteomyelitis in children or, if staphylococcal infection is specifically being treated, Empirical therapy for suspected staphylococcal septic arthritis of a native joint.