title: A prospective study of 245 open digital fractures of the hand.
abstract: We report a prospective study of 245 open digital fractures of the hand in 201 patients. Management followed clear guidelines set out in protocol. The incidence of infection (2.04%) and non-union (2.45%) was low. Proximal phalangeal fractures and comminuted fractures did worst and associated significant soft tissue injuries had a particularly deleterious effect on the outcome. A classification based on the different soft-tissue components involved is proposed. In fractures associated with simple lacerations or isolated digital nerve injury only, one can expect about 40% good results and about 25% poor results. Where extensor tendon injury or extensive skin loss are also present, there will be approximately 18% good results and 50% poor results. If there is also injury to the flexor tendon or more than one component of significant soft-tissue damage, about 80% will be poor and good results are rare.
authors.affiliation: Department of Orthopaedic Surgery, Queen Mary Hospital, University of Hong Kong.
authors.forename: S P
authors.initials: SP
authors.lastname: Chow
authors.forename: W K
authors.initials: WK
authors.lastname: Pun
authors.forename: Y C
authors.initials: YC
authors.lastname: So
authors.forename: K D
authors.initials: KD
authors.lastname: Luk
authors.forename: K Y
authors.initials: KY
authors.lastname: Chiu
authors.forename: K H
authors.initials: KH
authors.lastname: Ng
authors.forename: C
authors.initials: C
authors.lastname: Ng
authors.forename: C
authors.initials: C
authors.lastname: Crosby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005383:Finger Injuries / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D005597:Fractures, Open / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000293:injuries; D008875:Middle Aged; D011446:Prospective Studies