Osteal panaritium is a purulent inflammation in the bone tissue of a finger.
Patients with osteal panaritium and its complications rate up to 18 % of outpatient
surgery. In 1.3% of cases an amputation of finger is performed. Ankylosis develops
in 1.5%. The treatment may last up to 30 days and more. The causes of bone panaritium
occurrence are different: infection of finger bone, corn, microtrauma.
Scientists of the Center introduced laser osteoperforation for treatment of bone panaritium.
This method was earlier developed for osteomyelitis treatment and proved to be sparing and
acceptable. Operations are carried out in outpatient conditions or in conditions of a
one-day hospital. In most cases one session of laser osteoperforation and aseptic bandage
(for 1-2 days) is enough; in contrast to the traditional methods for which daily dressings
for 6-7 days, drainage of purulent sinuses with antiseptic solutions and antibiotic
administration are necessary, in some cases digital phalanx amputation is still performed.
Methods of treatment
Some holes in the zone of inflammation are perforated with high-power laser radiation,
delivered through the thin quartz monofiber with special thermostable coating. Then the
medullar channel thermotherapy with the lower power is fulfilled without extracting of the
light guide. Any additional incisions or drainage of soft tissues and medullar canal are not
performed. 3-4 perforations per involved digital phalanx are usually enough. The procedure
takes 2-3 minutes.
Eighty-six patients with bone and osteoarticular panaritiums were treated. Edema and tissue
tension decreased in some hours after operation; pain was eliminated and the temperature
normalized the next day. Purulent sinuses closed in 2-3 days. Bacteriological tests showed
the absence of pathogens in the focus 2-3 days after the operation.
The disease recurrences were not marked. General duration of disability was 3-5 days
(28-30 days for traditional treatment), complete recovery according to X-ray data was
achieved by 40 day (60 days for traditional treatment).
