Treatment of Osteomyelitis of the Distal Interphalangeal Joint With Antibiotic-Impregnated Calcium Phosphate Paste Granules

Septic arthritis of small joints with associated osteomyelitis is difficult to treat and repeated surgical debridement and prolonged antibiotic administration are often needed. We report on the surgical technique and outcome of 3 patients with chronic arthritis and superimposed osteomyelitis at a distal interphalangeal joint of the right index finger. All patients were treated in a single surgical stage consisting of irrigating and debriding the tendon and tendon sheath, and filling the distal phalanx and middle phalangeal bone marrow with granules of calcium phosphate cement impregnated with vancomycin. No patients showed signs of recurrence of infection at 1 year or longer after operation although all progressed to autofusion of the distal interphalangeal joint.