Functional results of primary repairs in spaghetti wrist lacerations

Aim: Evaluate the outcomes of patients treated because of spaghetti wrist laceration in Cukurova University Faculty of Medicine in the Division of Orthopedics and TraumatologyMethods: Between August 2003-August 2010, Cukurova University Faculty of Medicine in the Division of Orthopedics and Traumatology, whether, nerves, tendons and the vessels repaired in 57 patients operated for spaghetti wrist lacerations reached from the 93 patients are considered. From the files of the patients, preoperative, early postoperative inspection and examination informations are obtained and in the last control, functional results obtained from examinations, evaluated according to the classification of the Lister finger range of motion scale, Seddon and MRC classifications, DASH Score for wrist and ROM, two points discrimination test, grip strength, tendon and nerve repair stages, Elektronorinogram results, Allen test, Limitation of Opposition and The presence of clawing, age, type of laceration, the laceration reason, profession of patient groups, the methods of rehabilitation, intrinsic muscle aktivity and power, capability of returning job were included.Results: In 57 patients, 54 patients were male and 3 were female. Average age was 26.6 (8-63). In 57 patients, 85 (44 ulnar, 41 median) nerves, 74 (28 radial, 46 ulnar) arteries, 26 extensor side tendon and 538 wrist and finger flexor tendons were repaired. Mean early follow-up period was 7,2 weeks, mean late follow-up period was 45.4 months. Post-operative period, patients rehabilitated according to Kleinert and Duran-Hauser rehabilitation procedures. According to the Lister scale %51.9 excellent, %23.7 good, %17.4 average, %7 poor results, by Classification of Seddon the Median Nerve 13 (%31.7) patients had excellent, 16 (%39.2) good, 10 (%24.4) moderate, 2 (%4.9) poor results, according to Seddon Classification of Ulnar Nerve excellent in 4 (%9.1), good in 16 (%36.4), 16 (%36.4) moderate, 8 (%18.1) poor results, according to Allen Test of the 28 radial artery 19 (%67.9) cases have open patency, of the 46 ulnar artery 28 (60.9) patients have open patency. 8 of the patients not able to return towards the patient's former job. Measured the grip strength loss, Capabilities to do job and lose of the ability to work, study.Conclusions: Spaghetti wrist lacerations are important emergencies of the hand surgery and treatment of injury requires high level of knowledge and skills, because of the long term complications that may limit patients' in personal life and in social life. Regular follow-up, surgical experience, appropriate surgical material, surgical method, effective rehabilitation therapy are the key points of the treatment.Keywords:Dash Scoring, Early Rehabilitation, Lister classification, Seddon Classification, Spaghetti Wrist Lacerations.