A prospective study of 245 open digital fractures of the hand
Chow SP. Pun WK. So YC. Luk KD. Chiu KY. Ng KH. Ng C. Crosby C. Journal of Hand Surgery. 16(2):137-40, 1991 May. 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.
Original Text by Clifford R. Wheeless, III, MD.
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