Houston Methodist. Leading Medicine

Wrist FAQ

Question:

No one knows how she did it but Mother left her assisted living unit, went outside, fell, and hurt her wrist. She developed septic arthritis (she already had arthritis in that hand) and now she's having emergency surgery. We just got the call from the director of the center. There were no details given. My husband is back on the phone trying to find out what's going on. I'm checking the Internet to find out how these kind of problems are handled. What can you tell me?

Answer:

Septic arthritis is a term used to describe an infection in a joint that can destroy the joint surface and underlying bone if not treated right away. Risk factors for this condition include preexisting arthritis, trauma, and poor health such as uncontrolled diabetes or the presence of other infectious diseases. With an injury like your mother experienced, a puncture or open wound allows for the entry of bacteria that can spread. Surgery is done to wash out the infection and clean out any remaining damaged tissue. A sample of synovial fluid is taken from the joint and sent to the lab to identify the infectious organisms. Once the culture has been analyzed, the most appropriate antibiotic can be prescribed. This type of surgery called irrigation and debridement is considered a surgical emergency when septic arthritis has been diagnosed. The goal is to prevent destruction of the joint, spread of the infection to the bones (a condition called osteomyelitis), and necrosis (death of the wrist bones). Irrigation and debridement for septic arthritis usually involves two of the wrist joints: the radiocarpal joint (between the forearm bone on the thumb side and the base of the thumb) and the midcarpal joints (bones that form the mid-section of the wrist). A saline solution is used to gently flush affected areas, then the surgeon scrapes away any signs of infection or damage from the infection. Hospitalization for several days may be needed to make sure the infection is cleared up and no further irrigation or debridement is needed. When there's only one area of the wrist affected, a minimally invasive procedure can be done with an arthroscope. This approach cuts down the amount of time in the hospital and reduces the need for repeat operations. Douglas M. Sammer, MD, and Alexander Y. Shin, MD. Comparison of Arthroscopic and Open Treatment of Septic Arthritis of the Wrist. Surgical Technique. In The Journal of Bone and Joint Surgery. March 2010. Vol. 92-A. Suppl 1 (Part 1):107-113.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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