Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, KY, 40402, USA.
Rabin Medical Center, Beilinson Hospital, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Arch Orthop Trauma Surg. 2024 Jan;144(1):537-542. doi: 10.1007/s00402-023-05115-2. Epub 2023 Nov 10.
The superficial location of the extensor tendons makes them particularly vulnerable to lacerations. Patients most commonly present to the emergency department (ED) after these injuries. We aimed to measure the safety of immediate surgical repair of traumatic open extensor tendon injuries in an ED minor procedure room (MPR) under local anesthesia, and the associated post-operative infection and complication rates.
We retrospectively evaluated all patients undergoing traumatic open extensor tendon repairs in the ED MPR over a 3.75-years period. Data collected included demographic information, comorbidities, mechanism of injury, additional procedures performed, and post-operative complications. All patients were operated under local anesthesia by a hand surgery fellow aided by an ED technician.
Two hundred and forty eight patients (278 tendons) were treated for extensor tendon injuries during the study period. 220 patients (245 tendons) have complied with follow-up. No intra-procedural medical complications were encountered. The post-operative infection rate was 1.4%. The rate of other post-operative complications was not related to the number of tendons repaired, additional digit involvement, or if the nature of the injury was work-related.
In this cohort, traumatic extensor tendon repairs performed in an ED MPR were found to be medically safe and to associate with a low postoperative infection rate. As preoperative assessment is simple and practical, and limited medical personnel is utilized, this surgical setting may enable us to reduce medical costs.
伸肌肌腱位置表浅，特别容易发生撕裂伤。这些损伤最常发生在患者就诊于急诊科（ED）后。我们旨在评估在 ED 小手术室（MPR）下局部麻醉即时修复外伤性开放性伸肌腱损伤的安全性，以及相关的术后感染和并发症发生率。
我们回顾性评估了 3.75 年内在 ED MPR 行外伤性开放性伸肌腱修复的所有患者。收集的数据包括人口统计学信息、合并症、损伤机制、附加手术以及术后并发症。所有患者均由手外科住院医师在 ED 技师的协助下局部麻醉下进行手术。
在研究期间，有 248 名患者（278 条肌腱）因伸肌腱损伤接受治疗。220 名患者（245 条肌腱）完成了随访。术中无医疗并发症发生。术后感染率为 1.4%。其他术后并发症的发生率与修复的肌腱数量、附加指的受累情况或损伤性质是否与工作有关无关。
在本队列中，ED MPR 中进行的外伤性伸肌腱修复在医学上是安全的，且术后感染率较低。由于术前评估简单实用，且所需医务人员有限，这种手术环境可能使我们能够降低医疗成本。
