Flexor Tenosynovitis – Franko

History: A 55 year old female with diabetes presented to my office with severe pain and swelling in her middle finger a few days after burning the tip of her finger.  This was initially treated with antibiotics for cellulitis however she rapidly progressed to flexor tenosynovitis based on the appearance and was taken to the operating room for urgent exploration, irrigation, and debridement of the tendon sheath. 

Diagnosis: Right middle finger flexor tenosynovitis

Treatment: Flexor sheath I&D followed by daily soaks

Outcome: Over weeks to months she healed the incision.  The flexor tendons required excision and she had limited flexion of the finger, but it remains infection-free.  She currently has very limited feeling in the finger.