Feel the Felon

Last time we discussed some ways to approach and manage the acute paronychia, but yet another unfortunate criminal robs our nail of its fine fettle: the nefarious felon. The felon’s early signs and symptoms may be subtle so don’t be fooled. This tender, fingerpad infection is not to be ignored. The enclosed fascial spaces of the fingertip pulp will be tender, and appear red and hot, which should mimic your aggressiveness and approach to stop it in its tracks. Figure out that felon, be tender, and forge ahead!   Some thoughts before proceeding. Your fingertip has thousands of nerves, and is very sensitive. Consider all the important things we do with our fingertips; pose for fingerprints, push elevator buttons, play Words with Friends on our iPhones. There are hundreds of reasons why we need to treat this part of our body cautiously and with respect. You can forever destroy the natural fingerprint and leave a tender scar if you make a large incision to drain the area. It could become necrotic and the patient may face amputation if you do not treat the infection. These infections are also very painful, so, please, do a digital block and treat pain appropriately.   The Approach• Digital Block with incision and drainage• Consultation with hand specialist   The ProcedureA felon may develop as a result of trauma to the distal finger or from a foreign body such as a splinter or thorn. It is a closed-space infection, usually caused by Staphylococcus aureus or MRSA. Earl...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs