Remove packing in 2 days. Osteomyelitis involving the diaphysis of distal phalanx is a common complication. The most serious complication is acute tenosynovitis, which may result from contiguous spread of infection. This is usually iatrogenic from inadvertent nicking of flexor tendon sheath with scalpel. Other complications include skin necrosis, deformity of the fingertip, septic arthritis, and instability of the finger pad.
Prognosis is excellent when treated early and appropriately.
Failure to check pressure and accumulation of pus in a closed compartment may lead to osteomyelitis and skin necrosis. Failure to perform judicious incisions may result in unstable tender fingertips or flexion contractures of DIP flexor crease. Instability of distal phalangeal skin and fat pad is a significant handicap that has resulted from traditional insistence on division of septa. Differential diagnosis for a felon includes herpetic whitlow. A paronychia can progress to a felon if left untreated.