Chow S P, Pun W K, So Y C, Luk K D, Chiu K Y, Ng K H, Ng C, Crosby C
Department of Orthopaedic Surgery, Queen Mary Hospital, University of Hong Kong.
J Hand Surg Br. 1991 May;16(2):137-40. doi: 10.1016/0266-7681(91)90162-h.
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.
我们报告了一项针对201例患者的245例开放性手部指骨骨折的前瞻性研究。治疗遵循方案中明确规定的指导原则。感染率（2.04%）和骨不连率（2.45%）较低。近节指骨骨折和粉碎性骨折预后最差，伴有严重软组织损伤对预后有特别有害的影响。我们提出了一种基于所涉及的不同软组织成分的分类方法。仅伴有简单撕裂伤或孤立性指神经损伤的骨折，预计约40%预后良好，约25%预后较差。若同时存在伸肌腱损伤或大面积皮肤缺损，则约18%预后良好，50%预后较差。若同时存在屈肌腱损伤或多处严重软组织损伤，则约80%预后较差，预后良好的情况很少见。
