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Updated: May 16, 2025
Passive movements and massage must be commenced as early as possible and be perseveringly employed to diminish the formation of adhesions and resulting stiffness. Subperiosteal Whitlow. This form is usually an extension of the subcutaneous or of the thecal variety, but in some cases the inflammation begins in the periosteum usually of the terminal phalanx.
This form usually follows upon infected wounds of the fingers especially of the thumb or little finger and is a frequent sequel to whitlow; it may also follow amputation of a finger. Once the infection has gained access to the sheath, it tends to spread, and may reach the palm or even the forearm, being then associated with cellulitis.
The placards and the caricature were prepared before the departure of the delegates; and it had been settled that Mat Paine, Dempster's clerk, should ride out on Thursday morning to meet them at Whitlow, the last place where they would change horses, that he might gallop back and prepare an ovation for the triumvirate in case of their success.
If this fails, or if the condition is allowed to go untreated, the inflammatory reaction increases and terminates in suppuration, giving rise to one or other of the forms of whitlow to be described. The Purulent Blister. This is commonly met with in the palm of the hand of labouring men who have recently resumed work after a spell of idleness.
Subcutaneous Whitlow. In this variety the infection manifests itself as a cellulitis of the pulp of the finger (Fig. 9, c), which sometimes spreads towards the palm of the hand. The finger becomes red, swollen, and tense; there is severe throbbing pain, which is usually worst at night and prevents sleep, and the part is extremely tender on pressure. When the palm is invaded there may be marked œdema of the back of the hand, the dense integument of the palm preventing the swelling from appearing on the front. The pus may be under such tension that fluctuation cannot be detected. The patient is usually able to flex the finger to a certain extent without increasing the pain a point which indicates that the tendon sheaths have not been invaded. The suppurative process may, however, spread to the tendon sheaths, or even to the bone. Sometimes the excessive tension and virulent toxins induce actual gangrene of the distal part, or even of the whole finger. There is considerable constitutional disturbance, the temperature often reaching 101° or 102°
In nerve lesions, such as a divided nerve-trunk, the nails are apt to suffer, becoming curved, brittle, or furrowed, or they may be shed. Onychia is the term applied to an infection of the soft parts around the nail or of the matrix beneath it. The commonest form of onychia has already been referred to with whitlow.
"Plucky girl, that!" murmured Mr. DeVere. While Estelle was being filmed down by the stream, one of the assistant camera men, a new hand, prepared to take a scene where a Southern farmer rides up to warn the Confederate cavalry of Estelle's escape, so they may take after her. Maurice Whitlow was the farmer. "Here, you!" cried Mr.
My Lady Delacour, I was going to observe that my principal has met with an unfortunate accident, in the shape of a whitlow on the fore-finger of her right hand, which incapacitates her from drawing a trigger; but I am at your service, ladies, either of you, that can't put up with a disappointment with good humour. I never, during the whole course of my existence, was more disposed to bear a disappointment with good humour, to prove that I was incapable of bearing malice; and to oblige the seconds, for form's sake, I agreed that we should take our ground, and fire our pistols into the air.
Cellulitis of the sole of the foot may follow whitlow of the toes. In the region of the ankle cellulitis is not common; but around the knee it frequently occurs in relation to the prepatellar bursa and to the popliteal lymph glands, and may endanger the knee-joint.
In a few cases, amputation well above the seat of disease, by removing the source of toxin production, offers the only means of saving the patient. The clinical term whitlow is applied to an acute infection, usually followed by suppuration, commonly met with in the fingers, less frequently in the toes.
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