by AceMedEd

Teach card · keep it in your scrub pocket

Pyogenic flexor tenosynovitis

Ask after the case (five minutes)

  1. First minute of the debrief: "Name Kanavel's four signs, show me each one on your own finger, and tell me which is often the earliest."
  2. Then: "Why is a flexor sheath infection a surgical emergency? Draw the sheath from A1 to the DIP, show me where we went in, and tell me which pulleys we kept and why."
  3. Last: "If this had been the thumb or the little finger, where could the pus have gone? Draw the radial and ulnar bursae and Parona's space."

Point at: the fluid as the sheath is opened, the pulley it was opened through, and the digital bundle kept in the flap.

End of day: "Draw me the incisions, then the sheath with its pulleys." Two minutes, no notes.

Where this kit and your technique differ, yours wins.

Send this to your students

Send it now. They prep alone while they wait, you stay with the patient, and you debrief for five minutes after the case. They won't see these questions.

Open the student page

Reviewed by Mehdi “AC” Talle, D.O., November 2026. Sources: Netter, Gray's Anatomy and Hoppenfeld's surgical exposures. Teaching schematic, not to scale; anatomy and technique vary. Management and indications are left to you on purpose.