Review Question: Felons

Regarding felons, which of the following statements is FALSE?

A. A felon is an infection of the pulp of the distal finger or thumb.

B. It differs from other types of subcutaneous abscesses because of the presence of multiple vertical septa that divide the pulp into small fascial compartments.

C. The incision should be made along the radial aspect of the index, middle, and ring fingers, and the ulnar aspects of the thumb and little finger, avoiding the pincher surfaces.

D. Any incision that is made too deep can injure the flexor tendon sheath.

E. Untreated, the expanding abscess can extend toward the phalanx, producing an osteitis or osteomyelitis.

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Answer

Answer: C

Most felons can be drained by a single lateral incision. The incision should be made along the ulnar aspect of the index, middle, and ring fingers and along the radial aspects of the thumb and little finger. The incision is begun approximately 0.5 cm distal to the DIP joint with careful avoidance of the neurovascular bundle of the fingertip. The incision is extended to the free edge of the nail. The wound should be irrigated extensively.  Most felons are treated empirically with anti-staphylococcal oral antibiotics for at least 5 days pending culture results.

Image: Draining a Felon

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