Management and functional outcomes of combined injuries of flexor tendons, nerves, and vessels at the wrist
β Scribed by Hassan H. Noaman
- Publisher
- John Wiley and Sons
- Year
- 2007
- Tongue
- English
- Weight
- 481 KB
- Volume
- 27
- Category
- Article
- ISSN
- 0738-1085
No coin nor oath required. For personal study only.
β¦ Synopsis
Abstract
A retrospective review of 42 patients with spaghetti wrist lacerations operated on by the author between June 1997 and May 2005 was completed. A total of 31 males and 11 females, average age of 17.1 years (range, 2β40 years), sustained spaghetti wrist injuries. The most frequent mechanisms of injury were accidental glass lacerations (55%), knife wounds (24%), and electrical saw injuries (11%). An average of 9.16 structures was injured, including 6.95 tendons, 1.4 nerves, and 0.8 arteries. The most frequently injured structures were median nerve (83%), flexor digitorum superficialis 2β4 tendons (81%), flexor digitorum profundus 2β4 tendons (66%), ulnar nerve and ulnar artery (57%), and flexor pollicis longus (40%). Combined flexor carpi ulnaris, ulnar nerve, and ulnar artery (ulnar triad) injuries occurred in 31%, while combined median nerve, palmaris longus, and flexor carpi radialis injuries (radial triad) occurred in 43%. Simultaneous injuries of both median and ulnar nerves occurred in 40.5%. Simultaneous injuries of both ulnar and radial arteries occurred in 14%. Neither artery was injured in 30.9%. Followβup has ranged from 1 to 8 years, with an average of 46 months. Only four patients have been completely lost to followβup. Range of motion of all involved digits (tendon function) was excellent in 34 patients, good in 3 patients, and poor in only 1 patient. Opposition was excellent in 31 patients, good in 5 patients, and poor in 2 patients. Intrinsic muscle recovery was subjectively reported to be excellent in 29 patients, good in 7, and fair to poor in 2 patients. Minor deformity (partial clawing) was reported in 4 patients and 1 patient has major deformity (total clawing). Sensory recovery was reported, excellent in 32 patients, good in 5 patients, and fair in only 1 patient. Β© 2007 WileyβLiss, Inc. Microsurgery, 2007.
π SIMILAR VOLUMES