Infections seeding implants are uncommon. In this case, a patient with rheumatoid arthritis and silastic metacarpophalangeal joint replacements developed infections of her implants associated with a calf abscess developing from a puncture wound of the sole of the foot. This patient had the implant surgery done elsewhere, and had done well for several years until a few weeks after she stepped on something sharp and developed a minor infection in the foot, which her doctor treated with antibiotics. Weeks later, she developed swelling, redness, and worsening pain in all of her hand joint replacements. |
Click on each image for a larger picture |
The old puncture wound. |
Right hand, bulging MCP arthroplasty abscesses. |
Left hand, same. |
Staph drained from all implants. |
Treated with continuous irrigation of all medullary canals following implant removal. |
Continuous suction within the bandage helped prevent a continuously dripping bandage. |
Preop films. |
And the culprit, which turned out to be a deep lower leg abscess which grew out the same bacteria as the implants. |
Incision and debridement of the calf. |
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