Prospective study of 80 volar wounds of the hand and wrist: Correlations between clinical examination and intraoperative findings
Autor: | T. Baron-Trocellier, M. Rongières, Elise Lupon, O. Mericq, Pierre Mansat |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Hand lacerations Physical examination 030230 surgery Wrist 03 medical and health sciences 0302 clinical medicine Tendon Injuries Humans Medicine Brachial Plexus Orthopedics and Sports Medicine Prospective Studies Prospective cohort study Physical Examination 030222 orthopedics Past medical history Missed Diagnosis integumentary system medicine.diagnostic_test business.industry Rehabilitation Hand Injuries Hand surgery Wrist Injuries Tendon Surgery medicine.anatomical_structure Blood Vessels Female Emergency Service Hospital business |
Zdroj: | Hand Surgery and Rehabilitation. 39:389-392 |
ISSN: | 2468-1229 |
DOI: | 10.1016/j.hansur.2020.03.006 |
Popis: | Hand and wrist volar wounds are a common cause of emergency room (ER) visits. These wounds are explored surgically in the operating room at most hospitals. The main objective of our study was to prospectively assess the correlation between clinical examination in the ER performed by a surgical resident and the tendon, vascular and/or nerve damage found during surgery in hand and wrist volar wounds. The second objective was to describe the lesions based on their mechanism, as well as their topography. Eighty patients from two hand surgery referral centers were included. Patients' past medical history was obtained, as well as records of their physical examination in the ER and description of lesions found during surgery. In 28% of wounds with a normal clinical examination, tendon, vascular or nerve damage was found on surgical exploration. Out of the cases that tested negative for tendon injury in the ER, 16% had partial tendon injury or digital tunnel wound discovered during surgery. Nerve damage was found during surgery in 12% of cases that had not been detected clinically preoperatively. Based on our findings, we recommend performing surgical exploration for all volar hand and wrist wounds in the operating room, as physical examination does not detect all tendons, vascular or nerve injuries. |
Databáze: | OpenAIRE |
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