Replies

1. 
   Dawid | Aug 21, 2010 08:13am | #1

   Hi

   From what you described that person developed septic arthritis. Basically it is infection of the joint.

   All the small joints in the fingers are synovial joints meaning they have a sheath or capsule encasing the two articular ends of the bones which in their turn are coverer by glass like cartilage. This encapsulatd space ( same as knee, hip etc. ) are absolutely sterile. With any injury that penetrates into this space, no matter how minute (ie a clothes pin etc ) there is a realistic chance of bacteria being introduced into the joint with subsequent infection, called septic arthritis. The fingers joints are not covered by much more than skin and especially when flexing your fingers the distance from skin to joint is quite small.

   Once the infection is established it can often turn nasty quickly as the bacteria starts producing toxins and body reacts to kill them also producing toxin, with the whole lot together basically forming pus as we call it. This all is toxic to the cartilage which in some cases can happen within hours or days . The cartilage damage is often permanent and without the glass like smooth cartilage you now have a situation in the joint where the two articulating ends are relatively rough raw bone grinding each other away ( painful ) or sometimes they ankylose, meaning the two bony ends grows together leaving you with a painfully stiff, or in the latter case a painless unmoveable joint.

   Nothing in medicine is absolute and its possible that only one in a hundred (?) such minute injuries might end up penetrating the joint and causing septic arthtritis.

   If in your case you have had an injury which is not settling there is any sign of infection ( red, pain, swelling, reduced range of motion or warmth ) even if it is away from the initial injury - see a doctor asap and make sure he knows something about hands, if in doubt see someone else. Thorns are notorious as the tip can sometimes nick the joint or even the bone casuing infection. i have seen cases where it did not casue infection but a reactive teno synovitis . Basically the sheath surrounding the tendon gets inflammed and thickened and the finger goes stiff as the tendon cannot glide through it smoothly. Hands are quite a specialist field and to be honest, some dr's knows about nothing about it.  Do not ignore it !! get prompt expert care.

   As a resident in orthopaedic surgery I've just completed a 6 month stint in a hand unit and it is amazing how poorly manual labourers look after their hands. Hand function relies on the incredible agilty and mobility of the fingers. However its is a intricate " pulley" system that does not respond well to insult with fractures of the fingers, injury to the tendons and most of all infections of the fingers very easily resulting in marked stiffness and therefor reduced function. SO PLEASE BEWARE. IF IN DOUBT, contact a doctor or even better, see one specialising in orthopaedics or hand surgery, because once its stiff its basically impossible to get it moving again !!!!!!

   I see the reply went a bit out of control, hope it helps. Let me know what happened please

1. 
   swenson | Aug 21, 2010 08:34am | #2

   It doesn't get any better than this.

   WOW !  SEND ME A BILL.  If I didn't know better I would swear that you wrote the original letter I was talking about.  Perfect.  What caught my attention was that the top of my thumb was numb, no feeling whatsoever, as well as bumped up between joint and nail.  I'll let you know what happens.  Thank you, Dr.  You are a gem.

2. 
   WillGeorge | Aug 21, 2010 09:22am | #3

   No Dr. here..

   No Dr. here..but I thought your post gave good advice. Loved your comment "Thorns are notorious as the tip can sometimes nick the joint or even the bone casuing infection.' Could I add wood slivers can be really nasty?

   Whenever I receive a sliver or thorn, I ALWAYS stop what I was doing, and go wash the area with brown soap and a finger nail brush. Yes, I still still have a few bars stored in a metal can. Brown soap is almost impossible to find. I keep a few fingernail brushes around in their original package. I never use a 'used' brush.

   OK, I ramble a bit.. I seem to heal well for almost any injury I have had in my life.. I'm getting much older so the healing process takes a bit longer than it did in the past.

   I MUST remove any sliver of wood or a plant thorn as soon as possible. My body attacks the intruder with everything it has for defences.. The swelling can be very painful!

   I am one of those "how poorly manual labourers look after their hands." Been a tank mechanic, metal worker, grunt labor, woodworker, car painter among many other manual jobs. I never thought manual labor was a bad thing. I had work with reasonible income to feed my family.. (Best job I have is being a nice grandfather to my 'little'/'big' offspring. Mostly very pretty girls/women) . Could a man ask for more?

   I messed up really bad one time. I was in the USA Army (1960 something) and I stepped onto a rusty nail removing a tank final gear case (stears the thing) from a wooden crate..

   As I remember we were NOT allowed to ask for help except if we were on the edge of death.  And then the officers would give ALOT of flack because of all of the paper work!

   I survived the pain. I can only bend my toes at the first joint. All further out member toe joints are like stone! I can walk well but my wife would make fun of me. She would pick up US quarters from the floor with her toes! She did that so I would forget how pissed off I was at the army for making me think I had no choice except to follow orders given...

   And I have broken these toes a few more times,,, long past the time I was in the military... I heal well but not in the correct order?

   And I have a old story about a woman doctor. She was very young and VERY pretty.. I came to the hospital clinic for her to remove a very deep splinter of wood.. She could not get it out so I asked her to 'slice it out' with one of her very sharp knives...

   She would not cut into me.. I grabbed her razor knife and cut.. IT hurt alot! Not very deep.. I am not that brave!

   She removed the splinter and I bet it was very hard for her, 'throught her tears for me or for her?'