This document discusses felon, an abscess of the pulp space in the finger. It notes that felon most commonly involves the distal pulp space of the index or thumb finger, resulting from minor trauma such as a finger prick. The pulp space contains fat partitions and becomes a closed compartment, so minor infections can lead to pus collection and increased pressure, compressing the terminal artery and potentially causing gangrene. Treatment involves antibiotics, drainage of the terminal pulp space through a longitudinal incision, and possible amputation of the terminal phalanx if osteomyelitis is present.

1. Dr.P.Masthan

2.  Superficial paronychial infections
1. paronychia
 Infections of intermediate depth spaces
 Deep infections
1. Palmar space infections
2. Pyogenic flexor tenosynovitis

3.  Infections of intermediate depth spaces
1. Pulp space infection (FELON)
2. Web spaces infection

5.  Felon is an abscess of pulp of the finger
 It may involve the terminal , middle or
proximal volar pulp space
 Most commonly involves distal pulp space

6.  Second most common hand infection
 Most commonly involves - index and thumb
 Results from a minor trauma,ex :- finger
prick

8.  Pulp space contains fat - partitioned by
septae
 Septae are attacthed fron periosteum of
phalynx to skin
 Terminal pulp space is a closed compartment

9. Minor trauma
Infection to the pulp space
Collection of pus in space
Increase in pressure in that closed compartment
Compression of terminal artery
Gangrene of the pulp space osteomyelitis

10.  Causative organisms –
1. Staph. aureus (most common)
2. Streptococcus
3. Gram –ve organisms

11.  Clinical features :
1. severe pain
2. Redness
3. Swelling
4. Fever
5. Tender axillary lymph nodes

12.  Complications :
1. extend toward the phalanx – osteomyelitis
2. obliterate vessels --- skin slough or necrosis
3. suppurative flexor tenosynovitis or septic
arthritis of the DIPJ
4. extend to form deep palmar space infection
5. septicemia

13.  Investigations
1. Xray of the part to check for the presence of
osteomyelitis
2. Culture and sensitivity of pus

14.  Treatment :
1. Antibiotics and analgesics.
2. Definitive treatment :-Drainage of terminal
pulp space by an longitudinal deep incision.
3. If there is osteomyelitis of the terminal
phalanx, it has to be amputated

15.  Definitive treatment :-Drainage of terminal
pulp space by an longitudinal deep incision.