PMC3342510_01
A: Clinical aspect of the left hand with swelling and redness, B: Unkempt dental status at the upper jaw with partially rotten teeth
GMS-10-09-g-001.jpg
PMC3342510_01_GMS-10-09-g-001.jpg
F1
An open wound of the hand was not detectable and due to pain and swelling no active motion was possible (Figure 1A (Fig. 1)).  Except for a cariotic dental status, associated with periodontitis (Figure 1B (Fig. 1)), the physical examination did not reveal further pathological findings.
A: Dorsal approach to the wrist with pus leaking out of the joint, B: pus inside the carpal tunnel, C: Aspect after debridement and D: Result after 10 months
GMS-10-09-g-002.jpg
PMC3342510_01_GMS-10-09-g-002.jpg
F2
Via dorsal approach we found a massive wrist empyema, which perforated into the carpal tunnel (Figure 2A, Figure 2B (Fig. 2)). A radical debridement was performed and almost the entire dorsal wrist capsule had to be removed (Figure 2C (Fig. 2)). Four days after the primary operation, secondary wound closure was achieved by local skin-distension flap and all wounds healed without problems (Figure 2D (Fig. 2)).