iii) Hand infections

Abstract Infections of the hand and upper limb present in large numbers to medical practitioners and represent 20% of admissions to hand surgery units. Infection can manifest in many different forms due to differing aetiological insults and the unique anatomical arrangement and compartmentalization within the hand. As a result, the significance and severity of these conditions at presentation are often not appreciated by both patients or medical staff. Prompt recognition and timely institution of appropriate treatment with splintage, elevation, antibiotics, and aggressive surgical intervention when indicated, can prevent permanent impairment, rapidly returning patients to their pre-morbid level of function. Time is particularly important as infection can spread rapidly, irreversibly damaging complex specialized tissues such as synovium and articular cartilage necessary for unrestricted hand function. Despite the advent and development of antibiotics, delay in presentation, diagnosis or treatment still results in increased morbidity and on occasion mortality, disability resulting from pain, stiffness, contracture or amputation.