Document Detail


Stenosing flexor tenosynovitis following a rattlesnake bite.
MedLine Citation:
PMID:  20608624     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Snakebite victims have been described previously in orthopedic literature in regard to complications such as compartment syndrome and carpal tunnel syndrome. We introduce a previously unreported complication of stenosing flexor tenosynovitis in a patient bitten by a rattlesnake. After being bitten in her right forearm, the patient experienced mild systemic symptoms of fever and nausea and was assessed at an outside hospital, where it was determined that she did not suffer from envenomation and therefore did not require antivenin therapy. She presented to our institution 1 week later with signs and symptoms of acute, new-onset right thumb flexor tenosynovitis, with pain and tenderness at the level of the A1 pulley of the thumb, with intermittent triggering. She also presented the following week with ipsilateral carpal tunnel syndrome. The patient reported no such symptoms prior to the snakebite. Given the recent development of these conditions after her snakebite, in addition to her history of endocrine disorders, we believe that our patient suffered from envenomation that led to these complications. Nonoperative measures including splinting and steroid injections were taken, with mixed results, and surgical intervention was necessary. While the proper management of snakebites is controversial, especially in regard to the administration of antivenin, we believe our patient would have benefitted from immediate evaluation and consideration for antivenin.
Authors:
Lydia Lee; Jeffrey Yao
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-07-13
Journal Detail:
Title:  Orthopedics     Volume:  33     ISSN:  1938-2367     ISO Abbreviation:  Orthopedics     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-10-14     Revised Date:  2010-10-26    
Medline Journal Info:
Nlm Unique ID:  7806107     Medline TA:  Orthopedics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  515     Citation Subset:  IM    
Copyright Information:
Copyright 2010, SLACK Incorporated.
Affiliation:
Baylor College of Medicine, Tempe, Arizona, USA. lydia.c.lee@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Animals
Crotalid Venoms / adverse effects*
Crotalus*
Female
Humans
Middle Aged
Snake Bites / complications*,  physiopathology
Tenosynovitis / chemically induced*,  physiopathology,  surgery
Thumb
Treatment Outcome
Trigger Finger Disorder / chemically induced*,  physiopathology,  surgery
Chemical
Reg. No./Substance:
0/Crotalid Venoms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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