A prospective study of the causes treatment and complications of acute hand infections admitted to Kenyatta National Hospital over a period of one year

Abstract

This was a prospective study that focussed on acute hand infections admitted to the Kenyatta National hospital's orthopaedic wards between 1 st July 1999 and 30th June 2000. A total of 78 patients were recruited into the study. Twelve (12) patients were disqualified from the study because they were lost during follow up. The mean age was 22 years with a range of 2-63 years and a standard deviation of 12.27. The male to female ratio was 2:1(53:25). There was no significant difference between the number of cases affecting the left and right hand (42 and 36 cases respectively). Minor injury was the commonest predisposing factor, involving 44.8% of the cases. The commonest reason for admission was tenosynovitis (32.5%), followed by web space infection (20.5%) and then cellulitis (16.9%). The commonest causative organism was staphylococcuS aureas, 43 patients, consisting of 55.1 % of all the cases. Surgery followed by antibiotic treatment was offered in 73.1 % of the cases (57 out of 78). Apart from the daily dressing following surgery, the commonest supportive treatment offered was self passive movements (44% of cases), while occupational therapist assisted passive movements was involved in only 9% of the cases. Professional occupational therapy was not offered in 91 % of cases. This may have contributed to the complications noted in this study. Restriction of joint movement was the commonest complication noted (21 cases) at a three month follow up functional assessment. Power and precision grips were unaffected by acute hand infections.